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In Defense of Social Security Disability Insurance

Over half the people on disability are either anxious or their back hurts,” Sen. Rand Paul (R-KY) said in 2015. “Join the club. Who doesn’t get up a little anxious for work every day and their back hurts?”

It’s a common line from conservative politicians: that the Social Security Disability Insurance program is just welfare for people too lazy to work.

Many of those politicians haven’t spent much time at all actually talking to the people they’re denouncing — people like Randy Pitts.

Before his body started to fail him, Pitts, a 43-year-old in Lake County, Tennessee, was a public servant. He loved his job as a 911 dispatcher for the county’s emergency services; he recounts with pride the story of the day he kept residents calm as trees crashed around them in an ice storm. He was elected county commissioner, a position he used to champion solar power.

Then in 2013, Pitts, who already had moderate arthritis and herniated discs in his back, was diagnosed with renal failure, an extreme form of kidney disease — the beginning of a chain of events that would leave Pitts and his family dependent on Social Security Disability Insurance (SSDI), which offers assistance for workers who develop disabilities and illnesses that render them incapable of working any longer.

Randy Pitts’ prescriptions
Randy Pitts displays his collection of daily medicines.
 Dylan Matthews/Vox

Pitts’s renal failure led to a medical emergency that left him with what a doctor told him was likely post-traumatic stress disorder. Too weak to stand and talk, he campaigned for reelection but narrowly lost his seat. At his dispatcher job, he struggled to remain calm and form clear sentences to reassure callers. In 2015, struggling mentally and physically, he had to give up his job; these days, he’s unable to dress himself without help from his teenage son.

Pitts’s son works, as does his daughter, who is in college. But the family’s major lifeline is the $1,196 per month Pitts gets through Social Security Disability Insurance — which has been, over the past several years, under intense political assault from the likes of Sen. Paul.

Randy Pitts with his mother, Diane.
Randy Pitts with his mother, Diane.
 Dylan Matthews/Vox

SSDI is not a welfare program. Just like Old-Age and Survivors Insurance, the more famous half of Social Security, it’s a social insurance program that only goes to people who’ve paid into it over the course of many years. It’s meant to protect against a risk that every employed person faces: the risk that one day their body will fail them and leave them unable to keep their job.

But the stereotype Rand Paul echoed, of the lazy SSDI recipient with occasional backaches, influences policy. President Trump’s 2018 budget proposed $72.5 billion in cuts to SSDI and to Supplemental Security Income, another program for disabled people, over 10 years. White House budget director Mick Mulvaney called the program "very wasteful" and bemoaned the fact that it "grew tremendously under President Obama."

Stereotypes about recipients wasting or not needing the money are common even among people on the program. “It’s harder for somebody that really needs it to get it than it is a dopehead,” Jeanetta Smith of Robbins, Tennessee, who has been on the program for 13 years, told me. “You’ve got these folks that don’t do nothing with it but dope it up.” (Insofar as the program has any kind of problem with drug abuse, it’s from Medicare, which insures SSDI beneficiaries, overprescribing opioids just as every insurer has.)

After visiting Tennessee, talking to SSDI recipients across the state, and scouring the rich economic literature on the program, I was left with a starkly different conclusion from the prevailing criticism. SSDI is not a gusher of free federal money for lazy people with backaches. It’s a stingy, hard-to-access program that helps some of the country’s most desperate citizens scrape by; applying takes months or years, and more than 60 percent of applicants wind up being rejected anyway.

SSDI is a thin piece of duct tape holding the American safety net together, ensuring people hit with severe medical misfortune have some means of survival. Cutting it without providing a viable alternative wouldn’t revitalize the economy or help disabled people find dignified work. It would leave some of the country’s most vulnerable without a way to get by.

Rocky Top, Tennessee.
 Shaw Poynter for Vox