Kentucky Health News
The number of Kentucky adults and children receiving disability benefits has increased in "staggering proportions," since 1980, says a report prepared by the state Disability Determination Services agency.
The study says that from 1980 to 2015, while Kentucky’s population grew by 21 percent, its combined disability enrollment grew by 249 percent, and childhood enrollment grew 449 percent.
By 2015, the report says, 11.2 percent of Kentuckians were receiving some form of disability benefit payment, higher than any state but West Virginia.
Eastern Kentucky had the top 12 counties in percentage of the populaiton receiving disability benefits in 2015: Wolfe, Owsley, Breathitt, Clay, Magoffin, Floyd, Lee, Leslie, Martin, Harlan, Perry and Bell.
The study also found that as the number of Kentuckians on disability increased, so did prescriptions for controlled substances. The counties with the highest rates of both disability and opioid usage in 2015 (in alphabetical order) were Bell, Breathitt, Clay, Floyd, Lee, Leslie, Owsley, Perry and Wolfe.
Opioid prescriptions among those receiving disability payments rose from 47.58 doses per person in 2000 to 147.29 doses in 2015, an increase of 210 percent. Nationally, the use of opioids increased due to a greater emphasis on the treatment of pain and aggressive marketing by opioid manufacturers, especially in Central Appalachia, which ranks high in share of the population on disability.
Central Appalachia has a relatively large percentage of workers who did not graduate from high school, worked in manual labor, and when injured found it difficult to get other work. Most of Kentucky's disability recipients have diseases of the musculoskelatal system and connective tissue (33.4 percent) or a mental disorder (32.8 percent), the report says. Other conditions included diseases of the circulatory, nervous and respiratory systems.
Most of the state's disabled children (70 percent) are enrolled for mental disorders. Those who got Supplemental Security Income benefits or were in Medicaid had a 168 percent increase in psychotropic prescriptions from 2000 to 2015, from 273 doses per person to 457 doses.
Bryan Hubbard, acting commissioner of the Department for Income Support, said in a news release, “The explosive growth of benefit dependence over the past 35 years has been fueled by a multitude of factors which are completely unrelated to the mitigation or treatment of hardship borne of genuine disability.”
A 2014 Center on Budget and Policy Priorities report says the number of disabled workers collecting monthly benefits tripled from 1980 to 2013, from 2.9 million to 8.9 million.
The report cites four factors for most of the increase: population growth, an aging population; growth in women's labor-force participation; and later retirements. It also offers results from several other studies with similar conclusions.
The Kentucky report suggests another reason. It says the federal Social Security Administration's culture is an obstacle to change because it is motivated to protect and expand enrollment for disability benefits in order to maintain its budget: “For the SSA, claims and beneficiaries equal budget. This simple equation drives the SSA’s internal culture thereby making it a significant obstacle to long-term change.”
The report calls for "radical reform," including making it a requirement that "objective medical evidence" be used to determine eligibility; removing all "subjective non-severe conditions" from the list of eligible conditions; requiring "mandatory termination reviews" for all recoupable conditions; and eliminating the "lost folder" policy, which restricts the re-evaluation of a beneficiary whose file has been lost, among other things.
The report speculates that rural rates are higher because rural populations are older. The share of people 65 and older in urban areas was 13.6 percent, compared to 18 percent in the most rural counties.
from Kentucky Health News http://ift.tt/2yjIWvz
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