Yet many of the people in the surrounding county, Buchanan, derive their income from Social Security Disability Insurance, the government program for people who are deemed unfit for work because of permanent physical or mental wounds. Along with neighboring counties, Buchanan has one of the highest percentages of adult disability recipients in the nation, according to a 2014 analysis by the Urban Instituteâ€™s Stephan Lindner. Nearly 20 percent of the area’s adult residents received government SSDI benefits in 2011, the most recent year Lindner was able to analyze.
According to Lindnerâ€™s calculations, five of the 10 counties that have the most people on disability are in Virginiaâ€”and so are four of the lowest, making the state an emblem of how wealth and work determine health and well-being. Six hours to the north, in Arlington, Fairfax, and Loudoun Counties, just one out of every hundred adults draws SSDI benefits. But Buchanan county is home to a shadow economy of maimed workers, eking out a living the only way they canâ€”by joining the nationâ€™s increasingly sizable disability rolls. â€œOn certain days of the month you stay away from the post office,â€ says Priscilla Harris, a professor who teaches at the Appalachian School of Law in Grundy, â€œbecause that’s when the disability checks are coming in.â€
Just about everyone I spoke with at the Grundy clinic was a former manual worker, or married to one, and most had a story of a bone-crushing accident that had left them (or their spouse) out of work forever. For Rose, who came from the nearby town of Council, that day came in 1996, when he was pinned between two pillars in his job at a sawmill. He suffered through work until 2001, he told me, when he finally started collecting â€œhis check,â€ as itâ€™s often called. He had to go to a doctor to prove that he was truly hurtingâ€”he has deteriorating discs, he says, and chronic back pain. He was turned down twice, he thinks because he was just 30 years old at the time. Now the government sends him a monthly check for $956.