In the mountains of Kentucky, in the coal country 100 miles east of Lexington, there's something in the water, something between defeat and government largesse. In Breathitt County, 4,000 of its 14,000 residents, or 28 percent, are drawing a government check because they've been ruled disabled.
The monthly checks in the tiny county where bodies seem to have failed en masse total $2.8 million each month, amounting to more than $200 for every man, woman and child it houses.
For as far as the eye can see from the wooded mountaintops, this is life in rural Kentucky and places like it. Of the more populous Pike County's 65,000 residents, 14,000 are on disability, for a total of $12 million in monthly federal payments. In Clay County, it's 27 percent of residents.
This area is also the most prominent on the accompanying EXography map of the U.S. showing the percentage of disability recipients among residents of each of the nation's more than 3,100 counties.
Some are likely miners injured toiling underground, though government disability programs are different than workers' compensation. But with coal jobs and other heavy industry work in decline, the absence of those jobs has probably motivated more residents to file for government disability than black lung ever did: Unlike unemployment insurance and welfare, there are no limits on the duration one can draw a check for being disabled.
Indeed, whether many of the residents are really disabled at all is an open question. When asked by the U.S. Census Bureau whether they had specific disabilities, only half the number of people collecting disability checks said yes.
Another condition has hit the Kentucky area like a plague, though it's not the sort of thing typically regarded as the result of too much dangerous work: obesity.
Most in Clay and neighboring counties who had little to no work history are drawing from Social Security funds they never paid into, as opposed to the disability trust fund for which onetime workers are eligible. It is, in short, welfare.
In Clay, the average person on the Social Security Disability Insurance rolls -- those who have a work history and paid in at least partially -- gets $910 each month. Disabled who have hardly ever worked, those on the Supplemental Security Income program, get $554 in an area where the average home can be bought for $46,000.
These are virtually all-white areas, and 84 percent of Clay voters cast their ballots for Republican Mitt Romney in the November presidential election.
In urban areas, denizens largely have other ways of drawing entitlements, although the disability money adds up faster in densely-populated cities, too. In the Bronx, 11 percent of 1.4 million residents draw a disability check, adding up to $109 million a month, or $79 for every person in the borough.
In Baltimore, 66,000 people draw disability checks, though that represents only 10 percent of the population, even though 1 in 4 residents described themselves as disabled on Census surveys.
The government will pay the disabled only if they do not work, and on Rhode Island Avenue in Northeast Washington, D.C., a former security guard who draws disability benefits for being too injured to work while also moonlighting as a bouncer under the table, had a major problem: a job offer.
"I got a call from a security company that they're hiring," the 45-year old man, who would not give his name to protect his benefits, told the Washington Examiner. "I can't do anything to jeopardize my disability check. Maybe I could ask them to pay me in cash or only work a certain amount of hours?"
Nationwide, nearly half of those collecting disability have no work history, with 10.6 million Americans on SSDI and 7.1 million on SSI, plus a million more on a version of SSI that is for the poor elderly.
The Social Security Administration relies on a decades-old manual of types of employment, geared to the industrial America of old, to determine whether a suitable job for a person exists in today's office-based economy. Social Security offices have made only hesitant and excruciatingly slow progress towards modernizing those criteria.
They "still do not take into consideration the full range of assistive devices" -- in other words, a person who is hard of hearing and says that keeps him from working doesn't need government checks for life, he merely needs a hearing aid -- as well as "workplace accommodations available today," a recent report by the Government Accountability Office found.
"SSA has disagreed with GAO's recommendation to conduct limited, focused studies on how to more fully consider such factors in its disability determinations, stating that such studies would be inconsistent with Congress' intentions," the report said, noting that Congress had never prohibited the SSA from doing so.