Posts Tagged "disability"

Downturns Attract Healthier DI Applicants

A theory – untested until now – about why more people apply for federal disability during recessions is that the depression, stress, or unhealthy behaviors caused by unemployment worsen their health and spur them to apply.

This explanation is largely ruled out in a new study out of Cornell University and the University of Illinois.

For each percentage point increase in local unemployment rates, more people with disabilities join the roles – about 45,000 more across the country. This finding, covering a period of 25 years, confirms what the existing research says about the connection between the economy and disability. Disability benefits, which average just under $1,300 per month, look more appealing when employment opportunities are scarcer.

When the researchers investigated why caseloads increased, they found evidence that seemed to contradict the hypothesis that people who apply during downturns are not as healthy.  Once they get on the disability rolls and become eligible for Medicare, annual Medicare spending on these new beneficiaries was slightly less than spending on the people who were already in the program.

Still, the researchers weren’t convinced the recession applicants tend to be healthier. Needing more evidence, they looked at Medicare spending for the disability beneficiaries who had applied to the program at 50. At that age, Social Security loosens the eligibility rules, making it easier to qualify.

The logic behind this part of the analysis is that the 50-year-old applies not because his medical condition or disability suddenly deteriorates after his birthday but in direct response to unfavorable economic conditions. Individuals pulled into the disability insurance program by the laxer rules are actually healthier: Medicare spends about $1,000 less per year on them compared to those who applied at 49.

The 50-year-old applicants are also more sensitive to a sluggish job market: for every percentage point rise in unemployment, the increase in new beneficiaries who’d applied at 50 was about five times more than it was for the 49-year-olds. …Learn More

Opioids

Opioids are in the Disability Community Too

Opioids fueled a record of nearly 100,000 drug overdose deaths in the United States last year.

The biggest cause of overdose deaths was dangerous synthetic opioids, such as fentanyl. But the epidemic involving illegal chemicals grew out of the abuse of highly addictive prescription opioids. A spate of new research reveals that the use and abuse of these prescription drugs have plagued people with disabilities, who often start taking them to treat painful musculoskeletal conditions such as arthritis or a bad back.

A 2017 analysis featured in this blog provided the first estimate of opioid use among people who have disabilities that limit their ability to work. The researchers found that about one in four people applying for federal disability benefits used the medications – a much higher rate than in the U.S. population overall.

Painkillers often do more harm than good because they can increase society’s dependence on disability benefits by impairing lung function, aggravating existing conditions like rheumatoid arthritis, or causing addiction. According to 2021 research by RAND that followed older workers over several years, the opioid users in the study were much more likely to wind up on disability than their counterparts who did not take them.

“Although the pain relief is an important health goal,” the researchers concluded, “the consequences to workers and social programs of powerful prescription painkillers are substantial and long-lasting.”

The isolation and stresses caused by the pandemic are believed to have fueled the dramatic rise in overdose deaths last year. But a long-running cause, prior to COVID, was the decline in U.S. manufacturing employment. Research reported in this blog directly tied the movement of robots onto factory floors to the rise in deaths of despair – from drug addiction, alcoholism, and suicide – among men between ages 30 and 54. The study found that automation accounts for nearly one in five overdose deaths in manufacturing counties, which are concentrated in the heavily industrialized Midwest. The researchers said the rate of applications for disability benefits is also higher in these counties.

Opioid abuse in the disability community is happening for the same reason it is pervasive in society: an ample supply of the addictive drugs. …Learn More

minimum wage text

The Economy, Minimum Wage, and Disability

The federal minimum wage is $7.25 an hour and hasn’t budged since 2009. But many states and some municipalities have raised their minimum wages. Today, more than half of the state minimums exceed the federal minimum.

Now a new trend has emerged: 19 states have enacted or approved automatic yearly increases in their minimum wages to protect their residents from inflation. These adjustments just went into effect this year in Arizona, Colorado, Maine, and Washington D.C.

How might higher minimum wages affect applications for disability insurance? On the one hand, the higher pay could prevent some people with mild disabilities from resorting to the fallback option: applying for disability benefits. But if small employers lay people off to cut costs or feel they can’t afford to hire workers at the new higher minimum wage, applications could go up. Facing fewer job opportunities, more low-wage workers might apply for benefits from a program that currently covers some 16 million Americans.

A new study finds that a rising minimum wage does, indeed, increase disability applications to the U.S. Social Security Administration. But the researchers stress that this impact is minimal compared with the increase driven by an economic downturn that throws more people out of work.

In their analysis of nearly 3,000 counties from 2000 through 2015, a one-dollar increase in the minimum wage added some 80,000 more applications to the disability program and its companion, the Supplemental Security Income program for the poor, elderly, and adults with disabilities. That represents a 2 percent increase.

Contrast that to the impact of a rising unemployment rate, which was about three times larger. …Learn More

Boomers Will Struggle with Care in Old Age

Granddaughter and grandmotherThe bulk of care for the nation’s elderly is informally provided by spouses, adult children, and other family members. But if family can’t fill the need, will retirees be able to hire an in-home caregiver or pay for a nursing home in the future?

Just one in five 65-year-olds has enough family and financial resources combined to provide the support they would require in the event they develop the most severe care needs as they age, according to new research by the Center for Retirement Research. At the other extreme, more than one in three will have insufficient resources to cover even a minimal amount of care.

The study builds on previous report showing that most retirees will eventually need some care, though only one in four is predicted to have severe needs. And one in five will not need any care. The new study used data from a national survey of older Americans to determine how many total hours of care are required for three different levels of need – minimal, moderate and severe.

For example, 924 hours of family or professional care per year are used by the typical person who gets minimal assistance, such as housekeeping or cooking for a few weeks or months. But people with severe needs receive nearly 2,300 hours of care per year – with half supplied by family members. This would add up to more than 11,000 hours over a five-year period, which is the length of time the researchers used to define severe care needs.

Next, the researchers calculated how many hours of care could be covered informally by family and how many hours of formal care the retirees could purchase with their income and any financial assets. If the total hours of care they can cover with their resources fall short of what is required for a given level of need, then retirees have insufficient resources to meet that need.

Unmarried women are in the toughest position, because they lack not only a spouse to take care of them in old age but also the financial advantages enjoyed by married couples, who tend to be wealthier than single people. Over half of unmarried women will not be able to cover even minimal care needs. In contrast, only a third of couples could not provide for any future care.

There are also big disparities by race: nearly half of older Black Americans and two-thirds of Hispanics do not have the family and financial resources to provide at least minimal care, compared with only a third of whites. …Learn More

Federal Aid May Help Kids Later in Life

Handicapped student in the library President Biden has said he wants to increase the benefits in a federal program for low-income children and adults with disabilities. But a long-running debate about the program is whether the direct cash assistance helps children when they grow up.

The Supplemental Security Income program, or SSI, clearly has immediate benefits. SSI provides nearly $800 in monthly cash payments and Medicaid health insurance to help parents care for their children and teenagers and manage their physical, cognitive, or behavioral disabilities. However, policy experts disagree on the program’s long-term effects.

Critics say it creates a negative dynamic if it causes poor parents, consciously or unconsciously, to lower their expectations for a child in order to preserve the payments. If the child has a relatively mild disability, the stigma might discourage educational achievements that would ultimately boost his earnings potential as an adult.

However, one analysis in a new study found no evidence that the future earning power of children receiving SSI was affected. This analysis compared kids whose benefits started before and after a 2001 administrative change that led to more benefit terminations.

A second analysis supported the argument made by SSI’s proponents that the program has broader long-term benefits for children. The additional financial resources enable parents to provide more of the educational experiences, nutritious meals, or stable home life that can improve their children’s future prospects.

To assess the merits of this long-term benefits story, the researcher used a different, more indirect approach. This approach was based on a medical exam for 18-year-old SSI recipients that was introduced in 1996 to determine whether their benefits would continue. The researcher compared the future earnings of the younger siblings in poor families in which the 18-year-olds did and did not lose their benefits.

When the 18-year-olds retained their SSI benefits, their younger siblings earned more as adults than the younger siblings in families that had lost benefits. This pattern held true both for the younger siblings who received SSI themselves and for the siblings who did not receive SSI. …Learn More

Not Everyone Can Delay their Retirement

Retirement experts encourage baby boomers to hang on to their jobs as long as possible to boost their monthly Social Security checks and add to their retirement savings. If they can delay retirement to age 70, they have good odds of maintaining their standard of living.

That isn’t always possible, however, for the baby boomers confronting disabling physical impairments or health problems. Add to that the generally declining health of the older population over the past 20 years.

Working to 67But a new study has revealed a deep socioeconomic divide. More-educated older workers are actually able to work longer than they did 15 years ago, while less-educated older workers – and Black men in particular – are mostly losing ground.

To estimate the changes in working life expectancy for various groups of older workers, Laura Quinby and Gal Wettstein at the Center for Retirement Research considered three factors: life expectancy overall, how long the workers can expect to remain free of a disability, and the rates of institutionalization in prisons and long-term care facilities. The incarceration rate is relevant, because the young adult men who received the longer prison sentences that started being imposed a couple of decades ago are now in their 50s and 60s.

Between 2006 and 2018, working life expectancy increased by about one year for older Black and white workers in the top half of the educational ranking. This makes sense because more educated people tend to be healthier and have seen stronger gains in their longevity.

But working life expectancy declined in the bottom half of the educational ranking for Black men and for white men and women. The exception is less-educated Black women – they have seen a small increase in working life expectancy, along with a more substantial increase in longevity.

The researchers also estimated the share of each group who, at age 62, could feasibly work until age 67, which would lock in their full retirement age benefit every month from Social Security, and until 70, which would provide them with their maximum monthly benefit.

A comparison of two extremes – more-educated white men and less-educated Black men – dramatizes the divide. …Learn More

Disability Discrimination and Aging Workers

Older workerA unique situation faces older workers with a disability: apply for federal disability insurance now or try to hold on and keep working to retirement age.

Of course, people who leave the labor force and apply for disability are taking a risk: they might be denied the benefits. But another possible factor in how these situations play out are state anti-discrimination laws to protect people with disabilities, including older workers, from employment discrimination. If these laws can reduce discrimination, could they increase employment and eliminate the need for some older workers to apply for disability?

A new study suggests that state anti-discrimination laws have prevented some disability applications – if the laws are broad enough to provide better protection to workers with disabilities.

The state laws deemed to be broader set a lower burden for proving that the individual has a disability than the standard in the federal Americans with Disabilities Act (ADA). Under the ADA, individuals must prove that their condition “substantially” impacts their ability to function. Under this high burden of proof, many individuals with disabilities were not considered disabled under the ADA and did not receive the federal legal protections from discrimination.

The researchers analyzed whether the broader state laws limited the growth in disability applications between 1992 and 2013 by making it easier for workers at or near retirement age to remain employed.

Disability applications increased during that period for a range of reasons, from the Great Recession to a long-term deterioration in older workers’ health. But the basis for this new study was an increase in disability applications tied to a 1983 reform to Social Security. The reform reduced retirement benefits by raising the program’s full retirement age. Disability checks, which were not reduced, became more attractive to older workers relative to their retirement benefits.

But the researchers found that disability applications did not increase as much – and sometimes not at all – in the states with the broadest disability discrimination laws. The laws were especially effective in reducing applications by people getting close to retirement age. …Learn More