I once asked a man in his 30’s why he was on disability. He had fallen attempting to ford a swift stream while fishing. He replied: “Well, the judge said I have a bad attitude, I don’t like people and I can’t hold a job.” Shocking as it sounds, it wasn’t very different from other reasons I’ve heard. “I don’t remember, my Dad put me on it.” “I have anxiety.” “I have back pain.” (In ER because he fell from his horse.)

Physicians and social workers, who deal with more than theories and studies, more than ‘rights’ and ’social contracts,’ know the truth. The disability system in America is terribly broken. As the administration points its finger at physicians who commit Medicare fraud, it would be more enlightening to point fingers at the untold numbers of individuals with false, or at least spurious, disability claims.

Granted, this is a difficult thing to bring up, much less quantify. One will be summarily charged with cruelty, greed or intolerance for merely suggesting that a well-appearing, motorcycle riding patient, on full disability at age 25, might not need government support. Studies are seldom done in the progressive halls of academia to highlight the abuse of a government entitlement. These, after all, fly in the face of our national academic, political and regulatory ideology, according to which the individual is always the victim, and the state (i.e. taxpayer) is always required to be the savior and patron.

Studies aside, talk to community physicians and you’ll hear the stories. Talk to nurses, or paramedics; chat with welfare case-workers. Query police officers. Those of us who work with the patients on questionable disability know that it’s time for the government to do some serious reckoning. Or, as we say here in the South, it’s time for a ‘come to Jesus meeting’ with a large number of disability recipients.

This isn’t merely the rant of another ‘hard-hearted’ conservative. It is the reality of Social Security Disability, which may run out of money by 2017 according to Congressional estimates.

While media sources shake their heads and attribute this to the recent economic down-turn, it’s hardly a new phenomenon. And it’s not merely due to an economic downturn. Disability applications have been on the rise for years, and are worsened by generational worship of entitlement.

Disability, it seems, has become practically a career option for too many citizens. A teacher friend of mine asked one of her high school students what he planned to do upon graduation. ‘Go on disability for my nerves, I guess, like the rest of my family.’ Disability has come to be seen as another form of welfare. If you can’t get work, or if you don’t like your work, or don’t like to work (more than a few of those I’ve seen), then you simply ‘get your disability.’

Granted, it isn’t a lot of money per month. But don’t be fooled. The individuals we see in hospitals are often holding other jobs, or engaging in other forms of non-taxable commerce. And they almost always manage to have phones with data-plans, cigarettes, motorcycles, illicit drugs and alcohol. (And not a small number of children! I mean, just how bad can your back hurt, ma’am?)

Disability should be a fall-back for the genuinely needy. It should sometimes be a bridge to new training and careers for those who can be retrained or rehabilitated. It should not be a terminal career goal. And its provision is not simply kindness to the unfortunate, if they are unfortunately scamming the system. Even St. Paul, in 2 Thessalonians 3:10, said ‘If anyone is not willing to work, he is not to eat.’

We need un-politicized research. We need to be able to confront fraud with information and truth. (We need a reality show! “Disabled or Enabled? This season on Fox Reality!)

The truth is, this issue matters tremendously, both on grounds of economics and principal. Because fraudulent claims costs tax-payer money in a time when taxpayer money should be held precious. Equally if not more nefarious, disability fraud dishonors the many citizens who truly deserve, and rely upon, money from disability payments.

Sadly, government is too financially strapped, too intellectually bankrupt, and too cowed by political correctness to adequately confront disability fraud in America today.

It’s fascinating that something which is self-evident to many of us is completely shrowded in mystery right beneath the noses of the government functionaries who regularly, and increasingly, approve disability applications in the first place.

Edwin Leap is an emergency physician who blogs at edwinleap.com and is the author of The Practice Test.

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