The awkward cashier: How federal disability policy mangles its mission (+video)

LINDON, Utah — The Wal-Mart cashier holds his body stiff, bending when he walks, the strained look on his thinly-bearded face suggesting continuing discomfort, if not outright pain. It's a Saturday night in Lindon, the end of a long work day. But Dal Schrader is more than just tired.

Partially paralyzed, with one leg longer than the other, the 46-year-old married father of two walks awkwardly on his toes. He can’t hold a fork or a pen with his left hand, and the medicines that control his seizures leave his right side shaking, such that he can’t feed himself without spilling. Once intermittent, the seizures now occur weekly, and often at work.

When he was six, Schrader fell at a school playground. A blood clot followed, which led to a stroke, leaving half his body partially paralyzed, his mind clouded with short-term memory problems, his speech often halting and unsure.

Social Security Disability Insurance was built for people like Schrader, but to qualify, he must first drop to part-time and earn less than $1,010 a month while his claim is processed, which can take one to three years.

Many with less severe difficulties do qualify. Over the last 20 years, the disability rolls have burgeoned. In 1989, just 2.3 percent of Americans aged 25-64 received SSDI benefits. Today, that number has jumped to nearly 5 percent, or nearly 9 million adults.

That jump was not cheap. In 1990, Social Security spent $20 billion a year on disability. Today, it spends more than $128 billion.

And much of this growth went to often hazy claims that are hard to prove, including mental disorders and back pain. And many are not so much disabled as they are economically bypassed.

“When coal prices fall there is a surge of disability applications out of the Appalachian region, said David Autor, an economist at the Massachusetts Institute of Technology, adding that people with back ailments or low level depression tend to tough it out until economic desperation forces their hand. They lose work, they look around, they cant find anything, and they get desperate. Eventually, they turn to disability.”

The rising burden of disability falls on every American worker. The fund pulls 1.9 percent from everyone’s payroll taxes, and that fund will run dry as early 2016, by current estimates. The Social Security Administration will then divert already overstretched retirement funds, tap an already empty general treasury, cut benefits, or clamp down on eligibility.

Like most federal entitlements, the disability program faces an existential crisis, as limited resources stand in the way of ever-expanding expectations.

Later this month, a key Social Security advisory board will meet to fix the disability system by getting fewer false positives that drive up costs and fewer false negatives that chew up lives.

All or nothing

When SSDI was enacted in 1956, “an able worker could maintain a job and didn't need assistance from the disability program, but a disabled worker couldn't possibly work, and needed the government to provide income and medical care,” said MIT's Autor.

The 1956 disability law, still in force, treats a disabled worker as an oxymoron. You are either a worker or you are disabled — not both.

That model is now “totally outdated,” Autor said, “partly because work is more sedentary, and medicine can actually help you. But also because attitudes have greatly changed.” The very purpose of the 1990 Americans with Disabilities Act, he notes, is to integrate the disabled worker into the labor force, by compelling employers to be more accommodating.

“Many Americans are willing and able to work,” Autor said, but work limitations under current law “curtail their earning power and raise their health costs.”