The startling rise of disability in America (2013) | Hacker News Reader

The startling rise of disability in America (2013)

apps.npr.org

82 pointspseudolus131 comments

This article is nearly 15 years old (2013). According to center on budget and policy priorities, the number of SSDI beneficiaries has fallen from is peak in 2014. So this article was written about a trend that peaked a year after its publication and had reversed over the past 15 years. Odd that it would be reposted today.

https://www.cbpp.org/research/social-security/social-securit...

I think someone may have wanted to bring more attention to this because contrary to surface level opinion and the peak on the surface; there is actually a growing number of people who meet the requirements to be eligible for disability but who do not receive those benefits.

There's a longstanding fear, and one that seems well founded, where those that meet the requirements won't actually file for it because doing so will have an adverse effect on any potential future employment.

Disability discrimination during hiring is almost impossible to prove with AI these days.

I've heard horror stories from some people at the shelter where I volunteer. One guy apparently had a county representative check the wrong boxes on benefit documents by mistake during welfare processing, saying a person was disabled because of a health condition (sleep apnea iirc) when they weren't disabled or receiving disability, and those people couldn't even find retail work afterwards.

AI has opened the floodgates to all sorts of discrimination as a result of the weights and decision-making being a black box with no accountability.

> Fewer than 1 percent of those who were on the federal program for disabled workers at the beginning of 2011 have returned to the workforce since then, one economist told me.

Do they lose their "disabled" status if they go back to work? If so, that seems like a textbook poverty trap. Why risk losing lifetime free money for a minimum wage job that might not last?

Yes

I have a friend 'trapped' by government aid. They receive some benefits from being diagnosed with something as a minor and their father received a government aid that conferred to them. Its SSDI IIRC; the rules say they can't get married, can't own property, can't earn more than $X/unit of time.

The 27 years I've known them have been punctuated by my saying "what if you do this to solve your current issue" and the reply is "I'll lose my benefits"

I'm unfit to say if they need it; as in I am unsure if their life would be worse or better without.

Don't read too much into the setup, above; my memory is fuzzy unless I am directly talking to them about it, and even so they correct me like, "its not ssi it's ssdi," or whatever it is. This is to +1 with an anecdote.

I dated a disabled woman for a bit, and this is exactly how it was. Every possible solution to her situation had better be 100% guaranteed to work, because it was guaranteed to get her ejected from SSDI, never able to reapply unless she developed a new and unrelated disability.

She wasn't even allowed to save money for an emergency fund or a large purchase because there was a limit to how much liquid cash she could have at any time, and it was something like $2000. If she demonstrated an ability to save more than that, the bureaucrats would take that as irrefutable evidence that she was well enough off to not need help, and boot her from the program.

Every single thing about the way that program is administered actively prevents its users from bettering their situation.

a refrain i hear a lot from my friend, who does actually have issues, i wasn't trying to imply they didn't^, is, "What if i [go to school], get a job, and then something happens where i can't work, but they've already kicked me off? I'd be in a way worse position"

They could go to school and make enough money to take care of themselves, obviously, but the threat of losing the safety net is enough that they still never went to school, and have only worked for retail a few times over the years for maybe 6-12 hours a week, obviously at minimum wage.

^ just in case it seems that way.

No worries, I didn't take it that way.

I heard the same thing. Even if her condition were to be "cured", if it ever came back she'd be screwed. The system would take that as proof that her condition was fixable and was therefore not a disability.

>can't get married<br> This is the next frontier in marriage equality.

you joke but it means they can't get decent health insurance, since they also cannot work full time.

Pretty sure you get Medicaid if you are on disability, no?

But I'm from somewhere that has loads of people on benefits, but no one says "disability" it's medical retirement and they get around all the restrictions by doing gig work under other people's name, and then taking their split in cash 80/20.

I'll never forget the run-in I had with this corner of the labor market:

Back about 15 years ago I was running a small business in the auto industry. A guy who did deliveries for us (entire job: driving cars to people) who was in his early 20s found himself in a very minor fender-bender -- he rear-ended someone else. He claimed his twisted his ankle from the jolt (based on where he was resting his foot). Fine, no big deal.

He went to see a doctor shortly afterwards and immediately filed for a Worker's Comp claim. He then kept seeing that doctor and within a few weeks was given...permanent disability. Literally got a doctor to say he'd never be able to work again. Full sign-off. He of course was seen walking around just fine a few months later.

Absolute insanity.

The problem with disability in the US is it is very easy to get kicked off of it, so nobody risks earning or saving too much money (I think you must maintain under $2000 at all times?) or pursuing a potentially viable career unless it is a 100% guarantee, because you can't go back on disability later for something you had when you were kicked off it, even if it is a progressive disease. You need to show new symptoms that by themselves are disabling or another qualifying ailment.

And also getting on disability in the first place is such a huge pile of bureaucratic nonsense and bullshit to start with that you have to learn how to "game" the system just to get approval. It isn't setup to try and help people who need it, it is setup to disincentivize everybody as much as possible, even if you have serious brain damage, are nearly blind, and only have 3 fingers.

This grossly understates the current 2025 financial impact of the problem, and is directly linked to the ~$36 trillion debt.

There is a target to reduce Medicaid recipients by 4.8 million by 2033, by requiring them to attend school or volunteer 80 hours per month. That's a lot.

https://www.nola.com/news/politics/impact-on-louisiana-of-me...

In the next four years, nearly every state that has huge Medicaid obligations will be forced to restrict and reduce access simply due to budget constraints.

For example, California has 6.6 million enrolled in Medicaid and requires a staggering $85 billion federal assistance annual infusion for Medicaid. "People with disabilities composed 8% of Medi-Cal enrollees and accounted for 31% of spending".

California has 49% of the population on employer-provided health insurance. Only 5% purchase private insurance (Affordable Care Act). However, 22% of Californians are covered by Medicaid. That number is unsustainable, and Governor Newsom is already enacting measures to reduce enrollment and eligibility.

https://calmatters.org/health/2025/05/medicaid-work-requirem...

https://www.chcf.org/wp-content/uploads/2024/06/MediCalFacts...

https://calmatters.org/health/2025/05/medi-cal-assets-newsom...

California is not a great example, since they pay out to the Fed so much more than they receive, so that infusion isn't really an infusion when you consider the overall budgets.

Nit: "the Fed" means the Federal Reserve Bank, which does not collect taxes. "The US treasury", "the Federal government" or "Fedgov" would work in your sentence.

It was supposed to be "the feds", short for "the federal government", but missing the s led to autocorrect on my phone correcting it to "the Fed". I can't edit it now, luckily I think the message is still pretty clear.

It’s unfortunate that we can’t seriously consider universal basic income in the United States. If we provided every adult citizen with $13K annually during their working years, it could offer support to those unable to find meaningful employment without forcing them to declare themselves disabled just to survive. That label can take a real toll on a person’s psyche and limit their belief in their ability to grow or find better opportunities. We also have to be realistic and realize AI is positioned to replace a significant number of jobs in the next decade. A safety net like UBI will only become more essential moving forward.

That would require a total rethinking of our economic system. I doubt this will happen without any catalyst like war or revolution.

Not necessarily. The US government already spends >2000$ per adult per month. It would require a total rethinking of the role of government.

Spends on what? It's not like you can disband the military, not build roads and bridges and eliminate medicaid just because you send out a $1000/mo UBI payment.

If you want to consider just social assistance then the US government spends about $950B annually, and that works out to $2800 per year per citizen. To make it a livable amount you'd have to at minimum 5x that expenditure (and a lot more than that in urban areas).

The comment I was replying to proposed a UBI of $13,000/year or roughly what many people on disability currently live on. That would cost around $3.4 trillion annually, leaving over $3 trillion for everything else, including roads and the military. Of course, you'd still need to make cuts somewhere - likely from existing entitlement programs.

I just posted the number that entitlement programs currently use, and it is under $1T. So you're basically saying "it's easy to implement UBI, we just need an extra 2.4T/yr lying around somewhere" (which is equivalent to 1/3 our total budget). Scale it up to realistic numbers (no one is surviving on just $13K/yr, plenty of people need more than just average support e.g. for medical conditions) and you're easily talking $5T+.

It wouldn't be very comfortable, but yes - it's possible to live on that amount. Many people on disability do so today. If it's not enough and you're unable to work, you'd have to rely on savings, family, or charity. And yes, the idea would for UBI to account for over 50% of current government spending and to get rid of most existing government programs (except core functions like military and law enforcement). That’s why I ended my original comment with "it would require a total rethinking of the role of government."

By the way, I think you're overlooking the strongest criticism of my UBI proposal: that it would reduce the incentive to work, potentially lowering labor participation and, in turn, government tax revenue, which could make the system unsustainable. It's hard to predict whether that would be a real problem or not.

How can you not see that if everyone gets X amount of UBI, the cost of everything goes up until you can no longer live on X.

It is such basic economics I just can't believe we even have these debates.

It is something I would have thought of when I lived with my parents as a clueless teenager.

That's not how it works - inflation is a function of money supply, not of how it is distributed. Do you consider Milton Friedman a "clueless teenager"? I admire your self-assurance by the way...

> no one is surviving on just $13K/yr

There are many countries around the world where that would be normal, or even a sign of affluence.

We aren’t talking about many countries around the world, just one

Or we'd have to raise taxes by 2.4T dollars. Which isn't as extreme as it sounds, since we're at the same time giving everybody money. If 2/3 of the amount of UBI is paid for with increased taxes, the average taxpayer will come out ahead. "We're raising your taxes by $10,000" doesn't sound as bad as when accompanied by "and here's a cheque for $13,000". Bill Gates' taxes will go up a lot more than $13,000, but the average taxpayer will see a very small benefit.

The other benefit of raising taxes is that it will control inflation.

And $13K/year isn't enough to live on, yet many disabled people do just that. 4 people each getting $13K can probably live together on that. Living alone is a luxury.

And with UBI, there are no limitations on you supplementing your income on the side. One of the biggest criticisms of UBI is that everybody will stop working. If UBI is $13K/year pretty much only those who are unable to work will not supplement their income with work.

Or I could just keep my money instead of sending it to the government just so they can send it back to me. Cut out the middleman.

That's called a negative income tax, and it can be almost the same as a UBI. There are pros and cons. For instance, if you lose your job, you have to wait until next April before you get your NIT money.

If everyone gets $13k a year the price of everything will go up until people will no longer be able to live on $13k a year. Then you have to raise the UBI amount and then raise even more money by the government. Repeat.

To me, it is a non-starter unless you also had a massive housing build out to drive the cost of housing/rent down. We can't do that now though so that is also a non-starter.

Then even if you did massively build out housing, most the UBI will still be captured by rent/housing as some areas will become extremely low status and people will use the UBI to move to higher status areas.

All UBI really does if everyone gets it is change what $0 means. Not to mention, if you replace what people are getting currently from the government with UBI they are getting totally fucked. People on disability would get completely fucked since they are getting a basic income now but even though the UBI would be more in total, that will just purchase much less if everyone is getting the same amount.

> and a lot more than that in urban areas

Or, if the UBI is insufficient, you could work or move someplace less expensive.

Most anything else would feel unfair (as a result of being so) and tend to drive a cycle of inflation in the expensive urban areas rather than working against it.

If someone is saving money to make a downpayment on a house, they don't stop spending money on food. They will likely eat out less, buy less expensive foods, watch for sales, cut down on food waste, or find other means to reallocate some of their budget for food to savings for that downpayment. Yet they will not stop eating.

I'm not the type of person who blindly supports UBI. I think that it would be disasterous to implement it without rethinking how the economy should work and how UBI is going to address social woes. That said, I do think that it will be necessary in the long run. Money, may it be earned or granted, is a tool for people to make decisions. Traditional social programs pretty much does the opposite. It removes autonomy. It removes accountability. It doesn't much matter whether it is social housing (something physical) or conditional grants of money (which is a major focus of this article).

I agree. Some libertarian economists noticed that endless growth demands slavery-like conditions and the economic collapse one way or another. They are trying to back away without using the s-word and invent half-baked solutions like UBI.

UBI by itself will not solve the problems. It will only drive exorbitant inflation. Implementing UBI requires socializing many institutions and nationalizing big companies. People who control the biggest portions of the economy will not give their power up without a war.

> Some libertarian economists noticed that endless growth demands slavery-like conditions and the economic collapse one way or another.

Which economists? That doesn't sound libertarian at all. Libertarians who support UBI typically do so because they see it as a pragmatic alternative to inefficient welfare systems. They certainly wouldn't support abandoning market based economics.

Not just a total rethinking, but rather a total redevelopment to find an economic system that is just as stable as capitalism in a free market (without fiat).

Socialism fails 100% of the time given sufficient time, UBI is tied to socialism.

If your food production yield is dependent on maintaining your supply chain which fails under socialism, you basically run into a hysteresis trap under socialism where this fails, and everyone starves to death.

Its like the ending of Daybreakers, where blood becomes increasingly scarce, and the dynamics of it all force some unwilling sacrifices which start a chain reaction.

Just an FYI, Money-printing/non-reserve debt issuance is a catalyst for war/ revolution.

More safety equates to less people willing to work slave jobs for slave wages. They're just gonna make disability bucks harder to access.

Even with 100k / month basic income, the landlords would simply raise their rents to 200k / month. Because why would they give up their generational wealth?

In this model, does the current existence of people in poverty basically serve as a ballast that gives everyone else's "above poverty" money a higher, stable value?

Would it ever be possible to not have poverty without making everyone's money worthless?

You can always increase the labor by making more people and making more of them participate in the market. That is good because you can then start flattening the differences in income by taxation, so everyone gets richer (can afford more services) and you can also control the economic disparities.

The assets story is a different beast. They tend to be finite and the worse the economic disparities curve is the higher their price becomes.

How many condos are there andjacent to upper east side of Central Park? Let’s say 100. That number is fixed, and 1 million people on this planet want one. If they all had the same salary the rental price of the condos would be close their (same) monthly salary. Now because the economic disparity is huge there is a super low number of people that have super high income, but they are still more than 100. So these lets say 1,000 /1,000,000. These thousand folks can drive the rental of these condos to almost infinity.

those unable to find meaningful employment

I don't want to pay to feed freeloaders. If you want to, that's what charities are for.

If you hate the handicapped at least have the decency to kill them not let them starve on the streets.

And afterwards introduce genetic screening so that only Ubermensch are born.

What they do or not do is none of my business.

Someone at my work posted that because they have ADHD they were able to get a free lifetime pass to National Parks because being in nature calms them. I can’t believe some people. If you have the money to support national parks, pay for the pass. Don’t you realize if everyone does this we won’t have any more National Parks? They are at a Director level, they can travel, and somehow ADHD is a disability? You wouldn’t know it if they didn’t tell you every time they introduced themselves. They’re like, “Ugh ADHD made me so driven I got to the Director level it’s so stressful…”.

Eric Conn [1] is a fraudster who abused this with a scheme to bribe judges, doctors.

[1] https://en.wikipedia.org/wiki/Eric_C._Conn

I am a 100% P&T disabled veteran - I have handicapped parking and all of that.

I could sit here and list out all the medical and legally accepted reasons that the Veterans Administration, and as a result all other regulatory bodies, give me this status (epilepsy, constantly dislocating shoulders, hip arthritis, tinnitus, PTSD etc...)

However I have friends, colleagues and neighbors who are measurably less physically and mentally capable but are not considered disabled.

When I look at the job market, MOST people are not capable of doing their individual life without significant training, help, direction or supervision. People call this bad-state "adulting" and find it onerous.

Said another way, the vast majority of people do not have the cognitive ability, education (self taught or formal), or experience to set goals, take actions and self improve without significant direction from someone else. I personally consider that disabled.

So if these people are considering themselves disabled, then they are probably right - they are incapable of being independent or living within a community that takes care of them. So the only remaining community left is the abstracted transactional monetary system implemented by governments to allocate resources toward them provided they check the right boxes.

Ideally 100% of humanity would be on disability - because we can build systems measurably more capable than human labor - someone just needs to rebrand it as "UBI."

Interesting perspective. A lot of the nuance and disagreement comes from what we mean when we say “incapable”.

No, the view that "everyone should be on disability" is just socialism..

I would absolutely hate to have to think myself "disabled" and I would hate the idea of the state seeing itself as my "caretaker".

What you are describing is also the opposite from what liberal democracy was envisioned as. It was supposed to be a state, which created complete and mature citizens, which make well formed decision and can be trusted with governing the country.

To be honest I do not think that you are wrong in your description, the state is certainly transforming into an institution where the citizen are envisioned as disabled wrecks, which are in desperate need of government support. I just hate that this is the case, it is fundamentally incompatible with the ideals of a liberal democracy.

The fundamentally incompatible part is that the citizens are not complete and mature?

If citizens are broken people who need the support of the state they obviously can not make informed decisions and should not be allowed participate in politics.

The goal of liberal democracies is that the citizens are capable and mature and thus can be trusted with governing.

It was supposed to only count landowning males over 25, which was expected to consist of mature able citizens with assets.

so the problem is actually allowing renters to vote? that's a wild take I didn't expect to see on the orange site today but points for honesty and boldness I guess

I don't know what you are trying to say. Obviously what you are complaining about has changed and now all adults should be capable citizens.

Is it wrong that the state wants to create capable and mature citizens who can be trusted with participation in government?

He is suggesting that in the past, landownership was used as a proxy to determine who was a complete and mature citizen – and perhaps, most importantly, to determine who actually had skin in the game. Human bodies can leave a governing area with else, land cannot.

Times have changed. That model wouldn't work today for many reasons. But we haven't replaced the proxy with something that does fit modern times. Nowadays we see literal students who are still trying to become capable and mature citizens participating in government. And per the internet (take that for what you will), up to 40% of those students will move to a different jurisdiction after graduation, so not only are they not yet mature, there is little risk to them if their participation burns things to the ground.

Maybe that's okay. The world is our oyster to live in as we see fit. But it is noted earlier that it isn't how things were expected to be when our ideas about government were originally formed.

I’m saying you are completely wrong about what liberal democracy was envisioned as. Nobody thought the state had to create anything. People were believed to either be capable and worthy, demonstrated by holding assets - or not.

> liberal democracy was envisioned as [..] a state, which created complete and mature citizens,

you’re forgetting white, straight, and cisgender on that list

obviously it’s horrendously wrong but like someone else said kudos for speaking your “truth” or whatever

No, I don’t believe those attributes were in the law. You do realize I’m discussing historical fact, not personal preference, right?

Countries are created by adults and destroyed by children, and that's the normal stage of progress. The metaphorical adults, or the great souls, are experienced, self-directed and inspired by a vision of the great future. They know where they want to get and how to get there. The metaphorical children, or the young souls, live in the dark, clueless about what they are here for, so they chase minute distractions and learn by mistakes. However those mistakes is the only way to grow up.

I just applied to a job and part of it was a disability disclaimer. Here's the list:

* Alcohol or other substance use disorder (not currently using drugs illegally)

* Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS

* Blind or low vision

* Cancer (past or present)

* Cardiovascular or heart disease

* Celiac disease

* Cerebral palsy

* Deaf or serious difficulty hearing

* Diabetes

* Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders

* Epilepsy or other seizure disorder

* Gastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndrome

* Intellectual or developmental disability

* Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD

* Missing limbs or partially missing limbs

* Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports

* Nervous system condition, for example, migraine headaches, Parkinson’s disease, multiple sclerosis (MS)

* Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities

* Partial or complete paralysis (any cause)

* Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema

* Short stature (dwarfism)

* Traumatic brain injury

The form asks if you currently have or have ever had one of these in the past. Well, I don't know if anyone I've met hasn't. I said "no." I have no idea what the right approach here is.

If you want the job the right answer's going to be no. Unfortunately only a small fraction of those maladies gets you on disability, almost none of them before age 50.

Or say yes, then sue when they don't hire you.

Yeah... Asking that can't be legal, right?

It is legal to ask. You're not required to answer, and if you do answer then legally speaking the answer can't be shared with the hiring manager. This article has a good summary of the issue.

https://www.monster.com/career-advice/article/disclose-disab...

How can you say anything except no? Who, when applying for a job, wants to make themself look like a less attractive candidate?

The hiring manager probably doesn't see it, but recruiters and HR do, and they have a mandate to make sure that the company is hiring at least X% of people with disabilities.

In a world where 99% of resumes are never going to get seen by the hiring manager, checking the disability box might be the only way to have your application get past the initial recruiter/HR or recruiting-software screen.

I'd definitely not tick "low vision" and then straighten my glasses in a disapproving manner

> the vast majority of people do not have the cognitive ability

Fascinating. I'd love to know more.

Assuming your statement is true: If most people lack executive function, then people presenting ADHD symptoms are the norm, not the exception.

Accepting that hard truth would change society, right?

Not to get too into the weeds about UBI...

> Ideally 100% of humanity would be on disability

Do you mean 100% eligibility, regardless?

> someone just needs to rebrand it as "UBI."

Or maybe you mean the original "negative income tax" proposal? (What the kids today call "UBI".) So that everyone's guaranteed a bare minimum income.

In either case: I agree.

We'd be able to greatly simplify our patchwork safety network. No need for special consideration for pregnancy, family leave, eldercare, recovering from surgeries, etc.

My point is we have the mechanisms to implement UBI today if we want, we just choose not to.

And yes from my experience with people diagnosed with ADHD - IMO it’s an “adjustment disorder” for people who can’t fit into a rote directed life

On the opposite end people with high anxiety but can play the role of doing what they are told go far, but are mimics, and have nary a new thought or alternative view available to them.

"Somewhere around 30 years ago, the economy started changing in some fundamental ways. There are now millions of Americans who do not have the skills or education to make it in this country." Not wrong, and sad.

This article shows what Universal Basic Income looks like on the ground.

I thought disability is often the only way for people to get support when there is no other option for welfare.

I remember some article mentioned that the rise in disability correlated with the fall of welfare availability. (I didn’t read article so donno if covered)

Last Week Tonight did a great piece on the negatives of how SSDI disability works in practice: https://www.youtube.com/watch?v=hq2s7RMRsgs

Nothing compared to the NDIS rort in Australia. There is literal gang warfare over providing "services" to people with high payouts.

One thing I've noticed over the past 20 years. At least in the United States, we need less "ditch diggers." This means that those who are less intellectually capable find it harder to get employment in a suitable position. I think this is an issue that needs to be addressed. But you know, I live here and now, so that ain't happening.

Companies would rather hire an illegal immigrant than deal with someone who is not 100% mentally or physically fit.

> * At least in the United States, we need less "ditch diggers."*

There is no end to the amount of work that needs doing. Most of it "unskilled" labor.

Childcare, eldercare, planting trees, habitat restoration, ESL tutors, etc.

Sure, there is work that "needs doing". This doesn't mean there is anyone willing to pay to get that work done, especially at a livable wage that someone can base their life on (including some surplus such that they have slack to recover from making mistakes due to being less intellectual).

Even for something with an economically-demanded niche like planting trees, several guys with a shovel are beaten by two guys with a skid steer - putting us right back to the capital wins dynamic where the person who can afford to invest in the skid steer now bids down the now-surplus manual laborers who can't.

Eldercare could definitely use 2-3x the labor, but the whole goal of nursing homes is to turn the screws the other way. Then once you have staffing running extremely thin and unsupervised, the gatekeeping credentials become highly important.

> we need less "ditch diggers."

Fewer.

Make that a few, less one, with apologies to GP?

Sugar and inactivity are a hell of a drug.

So is inbreeding.

Chronic back issues...omg. You can literally exersize your way out of them. It's the only treatment and it is VERY effective. Living proof.

People run into back issues (very common and will probably happen to everyone) and doctors send them home with print outs showing them them how to repair their back. They throw the paper away and go back when "they need surgery." That makes it worse.

I have chronic back pain, recently diagnosed as osteoarthritis. I can attest that doing all the exercises the doctor's printout shows keeps the pain at bay.

This is as good a place to mention it as anywhere: My physical therapist told me that people who work at a computer all day have a high risk of osteoarthritis.

Get the Back Mechanic book. Author is a genius.

Some people need pain reprocessing therapy. Have you read the book The Way Out by Alan Gordon?

https://www.painreprocessingtherapy.com/ https://www.amazon.com/Way-Out-Revolutionary-Scientifically-...

This works for a lot of back issues but not all of em! For example syringomyelia, depending on where it forms, can be exacerbated by working out. So ideally make sure you have a good idea of why your back hurts before you start, but it can be hard to diagnose.

https://asap.org/disorders/articles/exercise-concepts/

Yeah, there are definitely edge cases but most back pain is self inflicted. The common knowledge around back issues is REALLY bad and doctors, oddly enough, do not help and are often ignorant themselves.

(2013)

I find it really surprising that a current affairs report of this sort is not clearly dated. I wonder if NPR do better with more recent articles?

VA disability is one of these big scams. People have gotten pretty good at transforming brands into money these days. So socially respected groups like firefighters or military use the chance to extract massive wealth from productive society.

Have you made any VA claims, or have you worked for the VA?

I know people who have done both, and profligacy is not something either would accuse the organization of.

AIUI, pretty much everyone can get a partial disability rating for tinnitus

Sounds...legit tho? I sure wouldn't want tinnitus, so if that can be softened, seems worth doing.

I think the implication is that people who don't have tinnitus can also claim it - there's no objective test to verify whether it's true.

Also, what is the point of a partial disability payment?

Is it to compensate you for the lost income you couldn’t have earned if not for the disability? That would be in line with the goal of normal disability.

I know a lot of 100%-disabled vets who had desk jobs while in, who are healthy, rock-climb etc. It's absolutely an abused system. Basically, you claim various categories, and get 10% disability for each category you claim.

edit: They usually have full-time jobs too.

When I lived in DC I knew several vets who received disability payments, worked well paid full time jobs at defense contractors and otherwise lived normal active lives. It definitely looked a little questionable

I recommend you search youtube for “va disability 100 percent” and witness the staggering number of channels clearly teaching people to game the system, complete with shush face thumbnails. There seems to be some profligacy from that angle.

Next you’re going to tell me that all those “get rich by buying my book” YouTube channels mean people must be getting rich by buying their books.

So are you saying all of the people who watch these channels (in your analogy they "buy get rich quick books") never try to get a disability status? or they try and never make it?

Or do they go for an interview, get their tinnitus, ibs, or chronic back pain diagnosis then try again for more next time?

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Look, I'm not saying we shouldn't help/trust veterans; My father is a severely disabled Vietnam war vet and gave up his body for the air force over a long career. He deserved to have his stairlift paid for by the taxpayer, but he shouldn't have to fight with corrupt service providers who can't do a proper job installing the thing. He shouldn't have to deal with a contractor that won't repair the botched installation for a year because it would cut into their profit margin.

Similarly, he shouldn't have his services degraded because other vets have found out how to take more than their fair share. I'm open to think there is minimal graft, but my experiences say there is some more going on than I can be supportive of.

Maybe you could provide some data to show how I'm mistaken.

You're the one making the claim and assumption and "gut feeling" so it sounds like YOU are the one needing actual data for your "gut feelings".

Sorry this is the same bullshit people do when they see a person able to stand for a few hours and say "WHY ARE THEY ON DISABILITY" and ignoring the rest of the time they aren't seeing, or the people recovering. This is just hearsay, and since you're the one making these claims, then it behooves YOU to provide the proof.

But it's a nice little racket, make a claim and then demand those who deny it provide the proof. That's now how science or respectable arguments work.

This whole thread is full of such bullshit. And it's so people can feel superior to those who they think are scamming the system (in an ever increasing need to "crack down" on those who "abuse" the system (slowly killing it over time, or until you can get a DOGE in and ransack it like a viking ship plundering coastal communities).

Anyways, citation needed, since you're the one making the claims.

go look back at my original statement. the tools to verify what I asserted are right there; go search youtube and see for yourself.

I'm not trying to feel superior, i'm trying to broaden my perspective by offering my own and engaging with people who comment on it.

I'm a veteran and I know several fellow vets who openly admit to lying to the VA to get disability ratings for maladies they don't have. No, I don't have statistics about how many disabled veterans are lying (how would one gather that information, exactly?), but it is a regular occurrence that I meet guys who brag about their 100% ratings, ask me about mine, and look at me like I'm some kind of poor naive idiot when I tell them that I did not claim disability because I do not feel that I'm disabled.

I do not claim that everyone on VA disability or SSDI is a fraudster. I know veterans who are missing significant portions of their body. I dated a women on SSDI who absolutely needed and deserved it for a neurological disorder. But she knew a family where every single member went on it as soon as they turned 18. Scamming SSDI was essentially their family business.

I am not advocating for DOGE to take an axe to these systems. But just because you or I might find DOGE distasteful does not mean that significant fraud and abuse does not take place. I can only assume that you have not spent much time around these systems or people who use them. Anyone who does immediately hears about their misuse, often from the perpetrators themselves, who are proud of their own cleverness for doing so.

There are entire online communities around gaming the system. On how to report pre-service injuries as service related. On how to deliberately build a huge medical file while you're in to support your disability claim later. On where to go and when, in order to get your highest possible rating. Things to say and not to say. There is an entire industry of paid consultants that help you get the biggest claim possible.

It's a big issue. Over 30% of vets today have disability compared to 15% in 2008. 3% of federal revenue goes to paying veteran disability alone and it's climbing. No politician can talk about it because campaigning on taking money from disabled veterans is the best way to nuke yourself in the polls.

we should have talked about it back in 2001 before we sent these young men to risk their lives and health in a misbegotten crusade. The rise in costs for veterans care was predictable: https://news.harvard.edu/gazette/story/2007/02/terror-war-co...

There's plenty of things to say about the waste and pointlessness of the GWOT.

But there were never enough deployments to justify these levels of disability claims. And not every person deployed goes into combat. And not every person that goes into combat becomes disabled. A rise was predictable. 30% simply implies a lot of a dishonesty.

I agree with you about the VA, although everything I know is secondhand.

I make two generalizations from veterans I know: one type accumulates injuries throughout service (neck, knees, hips, shoulders, back, toxic exposure) but being the walk-it-off types, never documented much because they were often deployed and didn't bother with paperwork. Bitterly complains about the VA and their limited or temporary disability ratings despite grinding pain and difficulty in later life.

Second type is similar to the first type, but played the 'game' optimally, documented, documented, and documented. While you can absolutely get some of the same injuries, I was surprised to find things like mild sleep apnea and male pattern baldness helped get someone a permanent 100% disability rating. No doubt life isn't easy, but to think this individual is 100% disabled is a bit of a stretch when they also work full-time for .gov doing project work.

My point is that like a video game, people are very good at finding the optimal or 'meta' path to maximizing outcomes in a set of rules, and outcomes from a system can be different than what casual observers might think is the intended purpose of the system.

> male pattern baldness helped get someone a permanent 100% disability rating

I find that very hard to believe. Do you have evidence that this is true?

As a veteran I haven't heard of that particular one, but I've heard of disability ratings given out for trivial enough things that I think it's plausible. I knew of one guy who got it for PTSD after being stationed in Okinawa doing an office job for 4 years. And I know another who has a rating for migraines, which he freely admits to not having and lying to the VA about.

I never applied for disability of any kind, but it would seem that the VA examiners question nothing and hand out ratings like candy. According to the migraine guy, it's one of those situations where they have to find things to spend their budget on or they lose it next year. I'm of the opinion that if they can afford to spend their budget supporting freeloaders and liars then perhaps it would be better used by some other office, but I digress.

I've mostly heard about the disability rating of the VA being a way the system screws people over using technicalities by judging them as 'partially able' despite there being few to no jobs that can actually utilize them. Hence the desperation to find some way to boost their percentage to something livable.

This needs a 2013 flag.

It's not startling at all. When people are paid to be disabled, what else would one expect?

I agree. Allow me to present a modest proposal...

It's like California paying more for homelessness each year and getting more homelessness each year

It’s not obvious, but I’m pretty sure this is from 2013 (I remember hearing it when it aired).

Confirmed - if you follow the "Listen to this story" link, it's from 22 March 2013.

Glad you posted this as I remember hearing about this situation some years ago but couldn't remember where.

Good catch! https://web.archive.org/web/20130326035330/https://apps.npr....

We've added the year to the title above.

Bread and circuses

It's probably obesity, lack of opportunity, and cultural normalization.

Can those be fixed?

A lot of people are people on Obesity... Which is what Kennedy is trying to fix and address. It is better to enable people to help themselves.

Big corporations have interest to have us weak and confused, from being perpetually single to other ways to make us dependendent on "services"

You think that an administration with good intentions of helping people would start off by kicking people off of the existing aid systems and tearing down institutions? Even institutions like the National weather service?

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