Getting Disability Isn’t Easy

Getting Disability Isn’t Easy; Living On Disability is Even Harder

Disability benefits are lower than most people believe.
They are harder to get than most people believe.
Fraud is far lower than most people believe.
And the amount of evidence you need just to be considered is far more than most people believe.

What most people never see is the long, exhausting process behind the scenes. The system is extraordinarily complicated. You must have multiple medical reports from several different doctors, all confirming that you are unable to work. Getting these reports costs a great deal of money, and it also takes a tremendous amount of time. Doctors’ appointments can take weeks to months to schedule. Many patients must then wait weeks to months to see specialists. Those specialists order tests and imaging that may require even more waiting. Some doctors will not make a final determination until you complete months of physical or occupational therapy. All of this is required just to build the months or even years of documentation needed for a disability claim.

You will also find that many doctors are hesitant to put in writing that you are “unable to work,” because doing so requires extensive paperwork that they are almost never compensated for. Even after all this, the disability office often overrules the doctor’s diagnosis or opinion. When that happens, the disabled person must appeal the decision, and many must pay out of pocket for additional experts to confirm what their original doctors already stated.

On top of this, you must prove that you have tried every reasonable treatment that might allow you to return to work in any capacity and that those treatments have failed. And you must do all of this while you are not working and have no income at all. Many disabled people spend years filing appeals, attending evaluations, and appearing before Administrative Law Judges. If they are denied, they must start the entire process again. And again.

There is another part almost nobody talks about.
During the first six months you are unable to work, you receive no financial support unless you purchased your own private short-term disability plan before you ever became disabled. If you had any medical history at all, you were probably not eligible to buy one. During this same six-month period, unless you are covered under a spouse’s insurance plan, you must pay for your own health insurance premiums or pay out of pocket for every medical visit, test, and treatment. People who have to rely on Medicaid or a very basic, low-cost plan often cannot access top-tier medical professionals. The wait times to see available providers are much longer, and many specialists simply do not accept those plans. Yet these specialists are the very people you must see in order to document your condition and prove that you are unable to work.

Government disability benefits based on your work history are not a handout. You pay into these programs every single payday of your working life, whether you are part-time or full-time. You cannot even apply unless you have enough work credits, meaning you have been significantly employed for the majority of your life.

But even if you qualify, the income is shockingly low.
Most people who are approved for disability receive about 40 percent of their former earnings, and they still have to pay federal income taxes at the end of the year.

Health insurance creates another huge burden.
If you qualify for disability based on your work history, you must provide and pay for your own health insurance for the first 24 months after you have been declared ‘unable to work’ (in addition to the first 6 months after you had to stop working.)  Only after that do you become eligible for Medicare.

And even when Medicare begins, it is not free. A disabled person must still pay the monthly Medicare Part B premium, deductibles, and co-pays. Most also have to buy a Medicare supplement and a prescription drug plan, because Medicare alone does not cover enough to keep them safely insured.

Typical costs for a disabled person on Medicare, under age 65 (per month):
• Medicare Part B premium: around $185–$200
• Medicare Part D drug plan: often $80–$100 or more
• Medigap (for example, Plan N): commonly $300–$600+ depending on state and health
• Co-pays, deductibles, uncovered medications: $50–$200+

For many disabled people under 65, these are not hypothetical numbers. For example, my own current costs are $94 per month for Part D and $530 per month for a Medigap Plan N policy, in addition to Part B.

This does not even include the expensive co-pays on many medications. Even with a drug plan, some disabled patients require medications that cost more than $250 per month, and that is with coverage. Because you are on Medicare, you are no longer eligible for the low co-pay programs that many pharmaceutical companies offer for high-cost medications. It is far more common than people realize for someone on disability and Medicare to need medications that cost more than their entire monthly disability payment. Many disabled people are forced to go without necessary medications that keep them alive. This leads to more hospitalizations, more medical complications, a worsening of their overall health, and eventually, death.

The government and the media rely on the public not understanding how difficult, expensive, and inaccessible this system really is. When the public believes disability benefits are easy to get or generously funded, it removes pressure to fix the system. It allows lawmakers to avoid accountability while millions of disabled people struggle in silence, financially punished for medical conditions they never chose. Nothing changes because most people simply have no idea how bad the system truly is.