Congress May Investigate ‘The Other Welfare:’ SSI

Some lawmakers are calling for an investigation into whether the decades-old Supplemental Security Income program, or SSI, gives perverse incentives to poor parents to put their children on psychiatric drugs to qualify for cash assistance.

SSI started in the 1970s to help parents care for physically disabled children. But the Boston Globe reports that SSI has now become “the other welfare” for poor families, who have come to depend on up to $700 a month in no-strings cash assistance and Medicaid coverage that the program provides.

We speak with reporter Patricia Wen, who found that a growing number of poor children are qualifying for the benefit because of mental disabilities, especially if they are put on psychiatric medications.

Boston Globe: Money and hard choices

We welcome comments from all of our listeners. Post below. Please stay on topic and be civil. Comments may be moderated by us, but you are solely responsible for the content of your comments.

Mike Marsten

Great discussion. Thanks very much.
I have a severely disabled 7 year old son with autism.
Does anyone know what the family income limit is to qualify for SSI? We make a good living but his medical bills take a good chunk out of it.
Ali

I do not have experience with the SSI issue, but wanted to speak to the question of medication. My daughter has ADHD with anxiety and has been medicated since preschool. It has taken a tremendous amount of pushback on our part, as parents, to keep her medication levels as low as they are. I absolutely feel pressured by her mental health providers to medicate her – and we are middle class, educated people who have the luxury of excellent health insurance and the ability to research all our options and act as our daughter’s advocate. I cannot imagine what it would be like if we were poor and not as well educated, because I do believe medication is overused, overprescribed and a quick fix and easy solution for health care providers.
Jennifer Pinder

I am a single parent with an 11yr old son with Asperger Syndrome and ADHD with some additional high functioning autism. When he was first diagnosed I refused to put him on medication. After his school did not want to deal with his behavior I was asked to remove him until he was under control. I had to take time from my job to stay home until a diagnosis could be made and find another school to take him. I received pressure from the teachers to medicate him. I have changed his diet. I have taken him to behavior therapy and neurofeedback therapy.
I have worked very hard with him to help him to grow as a person and to be able to interact with his peers. Every day is a struggle. There are new issues that come up when another is seemingly resolved. It is an endless game of Whack-a-mole. I have given so much time and energy in researching and trying anything that might help my son. It is a delicate balance to try and work a full time job and take care of a child with these issues. He is very demanding of my time and I never regret a minute when I see a sign that he is growing and developing. What takes you or I just a few minutes, such as brushing our teeth and getting dressed, takes him an hour and half. That is with constant refocusing and reminding him what to put on first.
I have not been able to get SSI for him. Although this additional income would be a help that maybe I would be able to work part time. I have had to leave several jobs over the last 5 years to work with him. It is never ending when you care how successful your child is. My children are everything to me. So, I need to voice that I struggle financially every day what I put out personally in alternative therapy in the hopes that something will work without medication.
Beth

My son was diagnosed with Bi Polar at the age of nine and he has never been able to received SSI even though he went to a special day school and was on medication. I have lost many jobs because of his mental illness over the years. Thankfully, he is now in high school and doing very well. He is off of almost all of his meds and is going to finish high school a year early.
Tom

I am from Britain, which has many faults, but this is not one of them though. Copy the UK System, not profit based (although you can go private if you want to.)

To Republicans who call it derogatorily “The welfare State”, I say to them Healthcare is not Welfare. It is a human right.

If you continue to violate human rights, eventually you will be called on it.
Angelique

I am a former Disability Determination Services employee with a state in the south, and was responsible for handling disability claims for both children and adults in my state. I found the story interesting, but what I am afraid will happen is that people are going to come away from hearing it thinking all you need to do to get your child on benefits is get him/her diagnosed with ADHD and put on medication.

That is false.

Ms Wen had the opportunity to make that point clear, but seemed to waffle on it when asked directly by Ms Young.

I handled literally thousands of claims for children whose parents claimed they were disabled because of ADHD. I put no child on benefits due to his/her ADHD, because they did not meet the definition for disability as defined by the Social Security Administration.
Bob

For parents looking for an alternative to medication, that is strongly supported by research published in respected peer-reviewed journals look for the David Lynch Foundation

Here is a video on this Dr. Sarina Grosswald:
http://www.youtube.com/watch?v=3gT8wopZJNQ
http://Adempsey22@gmail.com Anthony

Thanks for the discussion. I am an ER physician and I see many poor families with children on psych mess for various behavioral disorders. Unfortunately a pattern that we often see in the ER is that many of these children are obviously not cared for well by the parents. More often than not those children on psych meds are abused, malnourished, and very often neglected. I often wonder what is the problem…a biological psych issue or a problem with their environment. As a society, are we taking the easy way out by giving out and supporting these meds? Furthermore, these children get labeled as disabled at an early age and go through life with no motivation to make themselves better.
http://www.buildhopeandlove.com Home Building

I have many years of school experience with SSI and can assure you that SSI eligibility (and both the cash and Medicaid–Title XIX benefit) drives the exploding “diagnosis” of several disability categories, most specifically, autism and ADHD.

For example, ‘official’ figures put Denmark kids at ONE FIFTEENTH the rate of ADHD compared to USA kids. Our ‘medical systems’ have created statistical nonsense for us–as your Boston Globe reporter suggests.

I would add that the DSM is at fault here, as well. The specific assignment of mental illness nomenclature to all mild (remember that mild ALWAYS outnumbers severe many times–the bell curve, you see) cases cause permanent labeling that may impair future opportunities.
felicity

I was a teacher in a poor district in mississippi. The entire school received free lunch so that is an indicator of the lack of money here. I think there is a large amount of fraud involved with ssi money. The children even know that they must maintain poor behavior and,sadly, lower performance in order to receive their “crazy check” as they call it. There was even one instance where the fifth child in this one family was taken off ssi benefits because he was improving and starting thrive. This family had 5 children receiving benefits. This child was physically pulled out of class and violently shaken by his mother because she lost that extra income. Subsequesntly, he was re evaluated and put back on benefits. Four of these children are not in need and could do well but are forced into poor behavior and performance so that the mother can get her check, which never goes to benefit the children. This is only one of over a dozen instances that I have witnessed that are clearly fraud and creating a terrible pattern of failure and eventually crime in this community.
Nick

Why doesn’t the government focus on the cause rather than the symptoms of disease.
Healthcare is going thru the roof because of the way the FDA influences the public… and “food” policies created on capitol hill that support industrial food.
Ask who in congress and the senate: Who has watched http://www.forksoverknives.com

Our government (& the US Chamber of Commerce) is working for the corporations… not the people.
There is NO MONEY in healthy people… so they focus on putting bandaids on symptoms… instead of just eliminating the cause.

You folks at NPR and PRI are JUST AS GUILTY… because you haven’t done your own research… and therefore don’t ask questions that are probing enough.
If you keep up this incompetence… I wouldn’t have a problem pulling your funding either… just for the reason you are not working for the public!!!
My guess you are a sellout… because of where you get a large chunk of funding.

Suck on that one!!!
- greg johnson
  
  must be on the ssi rolls!!!
Ted

The SSI issue is being typecast as a program that is littered with fraud and abuse which is not the case. Looking at this program now is just another way to eliminate a program that affects the poor. The reason non-poor are not utilizing this program is because the non-poor is not eligible. SSI is a needs-based, means-tested program.

I worked for the Social security Administration for 26 years and now consult with individuals regarding entitlement to Disability benefits and SSI payments. It is untrue that merely being prescribed medication for an ailment entitles a child or any other individual to payments. An entire series of requirments are necessary and at least for children, the requirement that the child’s development must be negatively affected by the condition. Finally, the cash payment is not given for car payments, rent and the like. because these individuals are poor, they can not afford the treatment and development tools necessary for the children. These might include computers, special learning tools, tutoring or any other services. It might also include clothing.

The program is not wasteful nor is it fraught with fraud. It is just a program that is easily challenged because the individuals have very little representation and the program can be misrepresented as it is being now.
Melanie

I too think there is a large amount of fraud with ssi or ssdi money, for adults too. For example, clinical depression, the severe form of depression, improves spontaneously after several months, research shows, even without any treatment. Yet there are people who keep themselves labelled this way in order to keep the checks coming. As with the children, they have to take psychiatric drugs which have harmful side effects, sometimes producing permanent damage. And, as with these children, they need to continue to “act sick/crazy” even when they are better,and they can’t take on jobs or they will lose those benefits. These are crippling effects, for both children and adults. A lot of these “disorders” don’t have definite biomarkers, so it is just self reporting or reporting by a parent which keep the classification going. At the same time, there are children and adults living on the street or without even the basics, and they are getting no help. Where is the truth, justice and human dignity in this system?
WIlliam Hurley

The view I’m offering here is in response to hearing your discussion and interview with Globe reporter Wen. I’ve not yet read her article(s), but fully intend to ASAP. I expect I’ll then revisit the broadcast interview to tie together a more thorough and specific critique.

The opinions bandied about in the discussion by both Ms Wen and Ms. Young represent a case study in bad science, badly informed sociology, class bias, careless disregard for demographic and ethnographic information as well as the real conditions of Americans’ working and home lives in the 24/7 service economy.

One startling example of sheer absurdity – fueled by what biases or pre-concluded expectations is yet unknown – Ms. Wen and Ms. Young marveled in thinly veiled disgust at the fact (as conveyed within the interview framework) that more poor kids are diagnosed and then prescribed medications for psychological issues than wealthier kids. Truth be told, no matter how one chooses to slice demographic data regarding Boston, Massachusetts as a whole, New England, the nation or the entire globe the categories of “poor” and “wealthy” are never numerically equal. As such, disorders such as those referenced by Ms. Wen & Ms Young distribute across those classes in proportions equal to the size of the class. In short, there are – and remain – far more poor, working poor and “lower” middle-class than there are wealthy Bostonians, Americans or human beings. That there are numerically more poor children receiving treatment for the conditions discussed on-air than wealthy is neither surprising, aberrant nor relevant in determining the means or modes of treating the afflicted.

If there is, in fact, a distribution of these disorders and illnesses that are demonstrably skewed toward a rate of affliction that is distinctly imbalanced toward the poor and their families – then the logical, medical, political and humane response would be to direct more resources not less to the demographically larger group of citizens in need.

The analysis and tenor of the dialog between Ms Wen and Ms Young managed to accomplish a damaging and confused fusion of conditions and policy remedies. In short, the haphazard fusion of poor understanding of demographic and disorders’ realities with a response that endorses less treatment and less aid that’s lathered in what can only be an irrational skepticism of the facts at-hand – facts as expressed by the speakers themselves.

The observation offered here seeks to concisely surface merely one of the many deeply flawed aspects of the discussion, its tenor, content and disposition.

I hope to respond more fully soon.
Adrienne Nelson

I am the mother of 23y/o son who has been on so called psychotropic drugs and is diagnosed with ADHD,BiPolar disorder,major depressive disorder and learning disorders.I never sought out any diagnosis but responded to his attempted suicide,rages at home and school and poor grades despite high IQ and standardized school test scores. He was turned down for SSI 4 times. He got medicaid when I became ill and went on SSDI. I was very active in CHADD (Children and Adults with Attention Deficit Disorder) and NAMI (National Alliance for Mental Illness.)Both organizations fought for more treatment for children with mental,emotional and behavior disorders.Their perception being there was not enough treatment options for these children in all income brackets. I find my experience and many others to be in direct contrast to the conclusions of this report.
Ted

I agree with you fully Mr. Hurley. The discussion failed to highlight the fact that only the poor is involved in this program because the well to do is not eligible simply because they are well to do.
Rhonda Hoffman

This is an issue that has been burning me for almost 20 years. When welfare reform was taking place, many poor people found that SSI was the thing to turn to. I LITERALLY know a woman who has 8 children (grown now) and she was able to get every last one of her kids on SSI (pretty much made it a full time job filling out forms and taking the kids to the evaluation appointments) so multiply THAT times (at the time it was about $500 a month) and she was bringing in over $4k a month (while living in the projects, but eventually got a Habitat home) and there is not a THING wrong with these kids, nor has there been. My now estranged best friend (and no, I am not printing this out of spite, we just grew apart) put my godson on it (she has 2 other girls but I don’t know if she put them on it) and I LITERALLY remember her coaching him as to what to say when they had the evaluation doctors appointment. I know countless OTHER people who were on welfare, but found this to be a far more lucrative deal and would do and say whatever it took to get SSI. This has been such a scam for YEARS. I’m all for social safety nets and I know we are living in hard times, but there has got to be a better way…
Margaret Kibbee

I have to agree with the DDS worker and the person who worked with SSA for 26 years that you do not get on SSI by loading them up with medicine or just saying they’re ADHD. I’ve been a disability rep since SSI’s inception and can attest that this is a difficult diagnosis to prove disability under SSA’s rules. Claimants are reviewed by doctors who check to make sure that the child isn’t malingering. Teachers do questionnaires and have an opportunity to report parents who encourage their children to act poorly for secondary gain. Also, a teacher is a mandatory reporter and has a duty to report abuse (shaking a child for behaving) to authorities. I have seen far more people denied benefits who should have been approved (and eventually were in some cases) than people not disabled getting a check. An application has many gates to pass through before approval. The standard is a “medically determinable” impairment. What the parent says carries little weight.
Marie

I listened to this story with great interest. I too am a teacher at a low income school in the south. I have been teaching for 11 years, and have witnessed countless families who deliberately and actively SEEK diagnosis for ADHD and ODD so that they can get SSI checks. I have gotten cursed out by parents because I suggested that their child showed signs of giftedness. These parents are SAVVY– they know that they can get paid for their children if they have diagnosed issues that are deemed severe, and therefore they have NO vested interest in encouraging their children to thrive. This disheartening sabotage of childens’ futures is what ultimately led me to leave teaching. How can I help children if their own families subvert the system to keep them uneducated? It’s self-destruction in the worst way.
- DonthateBhappy
  
  so who would i talk to if I know this is happening to a little boy that needs my help badly
http://thestoppedclock.blogspot.com/ Aaron

There’s an underground economy that thrives on various forms of welfare fraud, and will happily assist people in qualifying for benefits for a fee, or in anticipation of profiting handsomely by providing “services”, perhaps only on paper, that the recipient doesn’t actually need. Yes, it can be very hard to get SSI if you do things “the way you’re supposed to”, but not everybody’s honest.
Patricia Reid

I was very impressed with this segment and after reading several of your viewers responses it appears that them majority of your
listeners are caring / loving parents, unfortunately this is not always the case. I have personally witnessed one women doing all
she can to keep one of her foster/adopted children on SSI. She is currently trying to have him labeled as incompetent/insane in order
to keep her monthly income at it’s current rate. It breaks my heart to see how this young man has been treated over the years.
There have been several individuals try to help him but find there is little or no protections of this type of abuse. This specific women has home schooled
or rather not educated any of her foster children so even if they do get out of her realm of control they are ill prepared for life and have
little resources to care for themselves. In Michigan CPS is not an affective agency and has done nothing to investigate his living conditions of this
family, nor has the court system. I for one would like to see reform that would prevent children from being exploited to this degree – as in this case. PR, Battle Creek, MI
Johanna Garsenstein

I agree with Melanie above that it is not only some parents of SSI eligible children taking advantage of the system – but it is also adults in general. I know one personally who procured SSI in the late 1980s because of a rape, serious drug abuse and resulting mental issues. While she has supposedly been clean and sober for years now and functions well in most ways, she works hard at maintaining her SSI/Medicaid coverage. There is no reason that this woman cannot work…except that she hasn’t really ever worked and getting a check in the mail is just so much easier. I do not agree with Ted above – this individual came from a family with means and has recently received a large windfall inheritance. Nonetheless, she continues to receive public assistance and the “system” doesn’t show the least bit of interest in re-evaluating such cases.
ssa

I am an SSA employee. I will admit that there is fraud and waste in the system. But there are also many children with Down’s syndrom, autism, and Cerbral Palsy that would not be able to survive without these benefits.

These children will never be able to work or qualify for regular Social Security Disabilty benefits. If this program didn’t exist, these children, now adults, would be a financial burden on their families. We help pay for health insurance, and if necessary, adult foster care.

These kids didn’t do anything to cause their conditions. I agree that we need to crack down on the abusers, but I also think that this is a necessary program for people who cannot afford care on their own.
Catherine

Regarding discounting a persons enviroment in favor of lables and medication- I have a story to tell. I was very very learning disabled growning up and I was in special ed classes and this made me the target of relentless horrible mobbing and bullying by my peers which was witnessed by the teachers and reported by me countless times. But it remained completely unchecked. Now this was back in the late 70′s when the effects of constant bullying was not taken as seriously it is now. Today I don’t know if I would have been protected-hopefully things are better. Anyway if this happened outside of school too, at the park or walking down the street, my classmates would threaten me walking down the street etc. It was all just good fun for everyone. I had no friends. Eventually when I was about 15 I ran away from home because my working class father wouldn’t by me the expensive clothes that would have made it all stop. Ok so I ran away by making myself a ward of cf the court and I was put in a group home for criminal minors and I felt safe there from those peers because of the strict discpiline But I refused to go anywhere but outside the insitution –because I was afraid people on the outside would attack me and laugh at me. Now here is where it gets interesting. They put me on medication because they were CONVINCED I was paranoid. Ad then they said I had schizophernia because I felt everyone was out to get me. I would have refused the SSI except I really had a horrible time with my learning disablites and WAS still terrifed of persons not in the system and –I was in truely horrible shape actually–but I’d say it was more post tramatic stress because of the bullying but nobody believed me that was was being bullied like that. It’s a long story but in the end there was no help for what was really wrong with me because it wasn’t until years later that people were dying on the campuses and people were starting to wake up. Till then I was in and out of hospitals with this lable –and still there is no real help for me because honestly people think peer bullying is like nothing.