After decades of planning, Social Security Disability Insurance was enacted into law in July of 1956. During the development of the Social Security Administration, planners debated how to define disability, as well as how to ensure disability was distinguished from unemployment (Berkowitz, 2000). In 1938, an actuary serving on the Social Security Advisory Council reported, “You will have workers like those in the dust bowl area, people who have migrated to California and elsewhere, who perhaps have not worked in a year or two, who will imagine they are disabled”(Berkowitz, 2000). Others believed disability was an “elastic concept,” and that the creation of too strict of a system would only invite pressure to polarize its implementation (Berkowitz, 2000).
The delay of SSDI’s integration into the social welfare framework of the nation is a reflection of the nation’s focus on WWII and the availability of public assistance at the time (Berkowitz, 2000). After the war, attention shifted to the necessity of rehabilitation rather than allowing individuals with disabilities to retire from the labor force and simply receive cash benefits (Berkowitz, 2000). A 1950 compromise Congressional measure created a new public assistance category: Aid to the Permanently and Totally Disabled. Prior to this, Aid to the Blind was the only disability-related public assistance program (Berkowitz, 2000).
The House, the Senate Finance Committee, and President Eisenhower’s administration spent several years passing and opposing a series of laws that set the stage for the passage of SSDI in 1956. One of the biggest compromises was to allow states to determine for themselves what qualified as a disability (Berkowitz, 2000). A lingering understanding from the early planners of SSDI that remained at this time was the stance that no benefits were to be offered to those with mental disabilities, arguing that mental disabilities were under the purview of state hospitals (Berkowitz, 2000). By believing that the provision of benefits for individuals with mental disabilities would encourage malingering, the structure of SSDI was unprepared to face the deinstitutionalization movement of the 1960s and beyond.
It would not be until 1972 that SSDI would be expanded to include mental health disabilities (Drake et al., 2009). Congress also created the Supplemental Security Income (SSI) program, a needs-based disability program for disabled children and adults. In short, SSI is open to individuals who are disabled, poor, and unable to work, while SSDI is open to individuals who are disabled or unable to work and who have worked in the past (or have parents who have worked) and have paid into the social security trust fund (NAMI, 2009). While benefits include coverage under Medicaid or Medicare along with cash payments, one of the most important benefits is the connection between SSI or SSDI enrollment and the eligibility for other local or state programs (NAMI, 2009).
In 2013, an estimated 3.5 million U.S. adults and children were enrolled in SSDI and 3.7 million enrolled in SSI had a diagnosis of a mental disorder (e.g. autistic disorder, Alzheimer’s disease, intellectual disability, mood disorders, schizophrenic and other psychotic disorders, etc.), accounting for about a third of total enrollees (SSA, 2014). The number of beneficiaries whose primary diagnosis is a mental disorder has increased over the last several decades, from 13.5% in 1982-1983 to 25.7% in 2002-2003 (Duggan & Imberman, 2009). Many point to the Social Security Disability Benefits Reform Act of 1984, which broadened acceptable definitions of disabilities, for the growing numbers of SSDI beneficiaries.
“It maintains our commitment to treat disabled American citizens fairly and humanely while fulfilling our obligation to the Congress and the American taxpayers to administer the disability program effectively” said President Ronald Reagan, at the signing of the Social Security Disability Benefits Reform Act into law in 1984 (Roy, 2013)
Currently, SSDI and SSI cash benefits are modest and its standards, according to the OECD, are considered the strictest in the developing world (Vallas, 2013). Aimed at replacing less than half of an individual’s previous earnings, SSDI benefits average $1,130 per month or about $35 per day, just above the federal poverty level for a single person (Vallas, 2013). SSI benefits average just over $500 per month or $17 per day, which is nearly half of the federal poverty level (Vallas, 2013). For most of the SSDI and the SSI’s beneficiaries, these cash benefits are the primary source of income (Vallas, 2013). Although estimates are uncertain for those specifically with mental illness, SSI income keep nearly 3.4 million Americans above poverty levels (Vallas, 2013).
Find out more about SSDI & SSI through the Social Security Administration’s website: http://www.ssa.gov/disability/
Berkowitz, E. D. (2000 July 13). Disability policy & history: Statement before the subcommittee on social security of the committee on ways and means. Official Social Security Website. Retrieved from: http://www.ssa.gov/history/edberkdib.html
Drake, R. E., Skinner, J. S., Bond, G. R., & Goldman, H. H. (2009). Social security and mental illness: Reducing disability with supported employment. Health Affairs, 28(3), 761-770. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828629/pdf/nihms175731.pdf
Duggan, M. & Imberman, S. A. (2009). Why are the disability rolls skyrocketing? The contribution of population characteristics, economic conditions, and program generosity. In D. M. Cutler & D. A. Wise (Eds.) Health at older ages: The causes and consequences of declining disability among the elderly. Chicago: University of Chicago Press. Retrieved from: http://www.nber.org/chapters/c11119.pdf
National Alliance on Mental Illness. (2009). Social security benefits: Are you or your relative entitled to social security disability benefits? Retrieved from: http://www2.nami.org/Content/ContentGroups/Helpline1/Social_Security_and_Disability_Benefits.htm
Roy, A. (2013 April 8). How Americans game the $200 billion-a-year ‘disability-industrial complex.’ Forbes.com. Retrieved from: http://www.forbes.com/sites/theapothecary/2013/04/08/how-americans-game-the-200-billion-a-year-disability-industrial-complex/
Social Security Administration. (2014 September 2014). SSI annual statistical report, 2013. Retrieved from: http://www.ssa.gov/policy/docs/statcomps/ssi_asr/2013/ssi_asr13.pdf
Social Security Administration. (2014 December). Annual statistical report on the social security disability insurance program, 2013. Retrieved from: http://www.ssa.gov/policy/docs/statcomps/di_asr/2013/di_asr13.pdf
Vallas, R. (2013 October 16). Nine facts that prove disability insurance isn’t a giant boondoogle. ThinkProgress.org. Retrieved from: http://thinkprogress.org/economy/2013/10/16/2787821/facts-disability-insurance/