Running head: SERVICES FOR INDIVIDUALS WITH INVISIBLE ILLNESSES

Policies and Services for Individuals

with Invisible Illnesses
Melissa L. Lafferty
Wayne State University School of Social Work

SERVICES FOR INDIVIDUALS WITH INVISIBLE ILLNESSES

Abstract
Millions of individuals in the United States suffer from invisible illnesses. During U.S. colonial
times, people pitied, shunned, and even killed individuals with disabilities. Laws such as the
Americans with Disabilities Act serve to ensure that people with disabilities are treated equally,
and programs such as Social Security and Supplemental Security Income were developed to
provide benefits to people with disabilities. When compared to disability programs in Great
Britain, Australia, and Japan, U.S. programs are not as effective in helping those with invisible
illnesses. Stigma associated with invisible illnesses prevents people from receiving benefits as
well as discourages them from seeking help and appropriate services. Public education and
advocacy by the social work profession could lead to changes in public health policies and
greatly benefit those suffering from invisible illnesses.

Policies and Services for Individuals

SERVICES FOR INDIVIDUALS WITH INVISIBLE ILLNESSES

with Invisible Illnesses

According to the U.S. Census Bureau, nearly 1 in 5 people in the United States have a
disability. Over 100 million individuals in the U.S. have a chronic illness, and approximately
96% of people who live with a chronic illness have an illness that is invisible (Invisible Illness
Awareness Week, 2013). Invisible illnesses are chronic conditions or disabilities, such as
fibromyalgia or chronic fatigue syndrome, that one cannot visibly see by simply looking at an
individual. Although many individuals with invisible illnesses are unable to work, they often do
not qualify for disability services or benefits because they appear healthy. Disability programs in
the United States are inadequate compared to the number of people with these conditions as well
as when compared to programs in other countries. In addition, the stigma associated with these
illnesses prevents people with these conditions from receiving benefits and discourages them
from seeking help and appropriate services.
Historical Overview
Elizabethan Poor Laws first classified those individuals with disabilities as the
deserving poor, which created social stigma and isolation (Appleby, Colon, & Hamilton, 2011,
p. 188). In early history, there was much shame and guilt associated with having a child with a
disability, and many felt that this meant that the family had sinned. Many parents would hide or
even kill their children whom born with disabilities (University of Washington, 2013). These
children did not attend school or receive an education. Even as people with disabilities became
more socially accepted, society viewed disability as a personal tragedy with which the individual
and family must cope. Many people pitied people with disabilities and their families, and charity
organizations were often started as a result. At this point in history, disabilities represented
weakness, and even successful individuals, such as Franklin D. Roosevelt, tried to hide their

SERVICES FOR INDIVIDUALS WITH INVISIBLE ILLNESSES

disabilities. Children with disabilities were not in the regular type classroom setting; they were
home schooled or segregated from other children. In the 1940s and 50s, parents organized and
advocated for education and services for their children with disabilities, but the children were not
routinely encouraged to advocate for themselves. Organizations focused on the prevention and
cure of disabilities, and even successful funding campaigns, such as the Labor Day Jerry Lewis
Telethon, often shared images of helpless children with disabilities and portrayed them as living
dismal lives.
Perceptions on disability in the United States and the fight for civil rights
significantly changed after World War II when many veterans with disabilities returned home
(University of Washington, 2013). The Equal Rights Amendment and the fight for civil rights
for black Americans during the 1960s inspired advocates to develop legislation to address the
discrimination against people with disabilities. Growing numbers of people with disabilities and
their advocates saw that it was not disability but rather an inaccessible environment and the
negative attitudes of others that were the greatest contributors to the restrictions that people with
disabilities encountered. The access to programs and services was a civil right that led to
legislations such as the Architectural Barriers Act of 1968, the Rehabilitation Act of 1973, the
Education of All Handicapped Children Act of 1975, and the Americans with Disabilities Act of
1990 (ADA). These laws mandated that people with disabilities have full access to education,
transportation, technology, employment, and other opportunities. People with disabilities now
had more available job opportunities and the opportunity to better themselves in the workplace.
In todays society, many people have been educated to view people with
disabilities with compassion, and as a result, major changes at the macro level have been
implemented. Many social systems are beneficial to people with disabilities, including religious

SERVICES FOR INDIVIDUALS WITH INVISIBLE ILLNESSES

affiliations, federal and state laws, disability support groups, the healthcare community, the
education system, and friends and extended family. People today are generally more accepting
of people with disabilities, as many people understand that a disability is not related to a life
error that an individual has made. Additionally, people with disabilities can and do live very
successful lives. Many scientific, medical, and psychological resources have been made
available to both individuals with disabilities and their families. This helps the family better deal
with challenges from society or the consequences of the disability.
Historically, invisible illnesses have been prevalent in society, but many were not widely
acknowledged until after the 1970s. Mental illness has been described in many early written
works, and anthropologists have discovered evidence of trephined skulls from early civilization
in 5000 BCE (Porter, 2002). Modern invisible illnesses, such as fibromyalgia, were first
studied in the 1800s, although the symptoms of fibromyalgia were called muscular rheumatism
in the 1600s (Fibromyalgia Symptoms, 2013). In 1816, University of Edinburgh surgeon Dr.
William Balfour gave the first medical description of fibromyalgia. In 1907, Sir William Gowers
named the condition fibrositis to recognize the tender points that patients with muscular
rheumatism experienced. It was not until 1987 that fibromyalgia was considered a real physical
condition by the American Medical Association. Many of todays invisible illnesses followed the
same pattern of acknowledgment as fibromyalgia. Today, over 96 million people are afflicted
with a medically acknowledged invisible illness (Invisible Illness Awareness Week, 2013).
According to Dr. Steven S. Overman, arthritis, musculoskeletal pain, and neuromuscular and
autoimmune disorders represent the most common causes of disability due to illness in the
United States today (Selak & Overman, 2013, p. xxi).

SERVICES FOR INDIVIDUALS WITH INVISIBLE ILLNESSES

Current Policies and Services

When the Social Security Act of 1935 originally passed, it included social
insurance and public assistance to those who were of a certain age or survivors of those entitled
to benefits, but it did not include benefits to people with disabilites (Social Security
Administration, n.d.). The main reason why disability insurance was excluded was due to the
belief that it would be too expensive to fund. During the Great Depression of the 1930s, the
number of disability insurance claims rose dramatically, and disability insurance companies lost
significant amounts of money. Many companies stopped selling disability insurance while others
financially failed (Soule, 1984, p. 4).
After many veterans returned home with disabilities after World War II, the U.S.
government developed a program called Civilian War Benefits, which was designed to assist
civil defense workers who became disabled in the performance of their civil defense duties
(Kearney, 2006). The program paid disability and medical benefits to affected individuals and
survivor benefits to their families. The Social Security Board was asked to develop and
administer the program because it had expertise in benefit payments.
In 1948, an advisory council on Social Security submitted a report that included
extending Social Security to cover disability, which led to the development of the federal
disability insurance program Aid to the Permanently and Totally Disabled (APTD) in 1950
(Kearney, 2006). In 1954, the Social Security Act was amended to include a disability freeze.
Under this amendment, disability was defined as, the inability to engage in substantial gainful
activity due to a medically determinable physical or mental impairment that could be expected to
result in death or to be of long-continued and indefinite duration (Kearney, 2006, 52).
On August 1, 1956, President Dwight D. Eisenhower signed the 1956

SERVICES FOR INDIVIDUALS WITH INVISIBLE ILLNESSES

Amendments to the Social Security Act into law, establishing the Social Security Disability
Insurance program (SSDI) (Kearney, 2006). Throughout the 1950s, disability coverage was
expanded to include benefits for dependents of workers with disabilities and adult children of
deceased or retired workers (Segal, 2013, p. 242). Essentially, the SSDI program was similar to
a retirement program and not very different from Social Security itself. There were several more
changes made to the SSDI program in the 1960s, including elimination of the age requirement
and reduction of waiting periods. The biggest changes, however, occurred in 1972 with the
creation of the Supplemental Security Income (SSI) program.
The SSI program is a federal program that provides cash payments to people who are 65
years or older, blind or disabled, and whose incomes lie below the poverty line (Kearney, 2006).
The payments are reduced by any other income received, including wages or other program
benefits (Segal, 2013, p. 322). The program was very costly, and as a result, it was revised in
1993.
In 1993, the Social Security Administration created the Disability Process Reengineering
Team (DPRT), which included a Revised Quality Assurance (QA) System (Kearney, 2006). In
1999, the Ticket to Work and Work Incentives Improvement Act was implemented, which
actively encouraged people to return to work. Eligible disability beneficiaries receive tickets
that they can use to obtain vocational rehabilitation, employment, or other support services from
an approved employment network or state vocational rehabilitation agency of their choice. After
many revisions to Social Security, there are still two distinct disability programs in place:
OASDI and SSI.
There are significant differences between OASDI and SSI. The SSI program is an
antipoverty program that taxpayers fund, whereas OASDI is social insurance that FICA payroll
taxes fund (Social Security Administration, n.d.). Beneficiaries of OASDI are generally people

SERVICES FOR INDIVIDUALS WITH INVISIBLE ILLNESSES

who have worked and paid into the system. Both programs define disability as:
(1) the inability to work if you can nor do work that you did before; (2) you cannot adjust
to other work due to a medical condition (as decided by Social Security); and (3) your
disability has lasted or is expected to last for at least one year or will result in death
(Social Security Administration, n.d., 2).
Over 54 million people in the United States are living with a disability. Additionally,
about 2 million people with disabilities live in nursing homes or other long-term care facilities
(U.S. Census Bureau, 2002). Some people are born with a disability, others become sick or have
an accident that results in a disability, and some people develop a disability as they age (U.S.
Department of Health & Human Services, n.d.). According to the Department of Health and
Human Services, just about everyone women, men, and children of all ages, races, and
ethnicities will experience a disability at some point during his or her lifetime, and the
likelihood of having a disability of some kind increases with age. For those 45 to 54-years-old,
22.6% have some form of disability; for those 65 to 69-years-old, the comparable estimate is
44.9%; and for the oldest age group, 80-years-old and over, the prevalence of disability is
estimated to be 73.6%.
According to the Social Security Administration, in October 2013, 10,964,000
people received disability benefits from disability insurance (OASDI). Of these beneficiaries,
about 8,936,000 were disabled workers; 157,000 were spouses of disabled workers; and
1,871,000 were children of disabled workers. In comparison, 8,381,000 people received SSI
benefits in October 2013. Of these beneficiaries, 1,317, 000 (or 15.7%) were 17-years-old or
younger; 4,955,000 (or 59.1%) were between 18 and 65 years of age; and 2,109,000 (or 25.2%)
were over the age of 65 (Social Security Administration, n.d.). Upon further examination of the

SERVICES FOR INDIVIDUALS WITH INVISIBLE ILLNESSES

data from October 2013, the total number of SSI beneficiaries who received benefits for
disabilities other than age and blindness were 5,036,868. In total, 13,972,868 people received
benefits from OASDI or SSI in October 2013, which is equivalent to approximately 25% of the
disabled in the U.S. This leaves over 42,000,000 people with disabilities (or 75%) without
benefits.

Much of the social stigma, prejudice, and discrimination

surrounding people with invisible illnesses are centered around fear and ignorance. Historically,
many people with invisible illnesses were believed to be hypochondriacs or mentally ill
(Corrigan & Watson, 2002). Most research studying invisible illnesses evaluated the stigma of
mental illnesses. Many people had misconceptions and stigmatizing attitudes about people with
mental illnesses, including that people with mental illness (1) are homicidal maniacs who need to
be feared; (2) have childlike perceptions of the world; and (3) are responsible for their illnesses
because they have weak character (Corrigan & Watson, 2002). Corrigan and Watson explain that
discrimination against people with mental illnesses may occur in four different ways:
withholding help, avoidance, coercive treatment, and segregated institutions. These four forms
of discrimination directly contribute to the lack of help that people with invisible illnesses
receive, as society does not like to acknowledge that a real problem exists.
Another significant stigma associated with invisible illnesses is the fact that these
conditions are invisible. Since people do not see a wheelchair or some other obvious sign of
a disability, many people assume that the person is not ill. In addition, there is stigma attached to
people who collect Social Security benefits. The U.S. values independence and hard work, and a
person who is collecting social security benefits when they appear to be perfectly capable of
working is often viewed as lazy. There is also much political pressure to decrease large tax
funded government programs such as SSI, as many Americans view these programs as wasteful

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or unnecessary.

A Global Perspective on Invisible Illness

Although Western doctors can take pride in the advanced abilities to offer high
tech-fixes, the U.S. has yet to match other countries in meeting the needs of persons with chronic
conditions (Selak & Overman, 2013, p. xxii). There are remarkable differences between the
public policies related to people with disabilities put in place within the nations of Great Britain,
Australia, and Japan when compared to the public policies in the United States.
Great Britains government defines a person as disabled if he or she has a physical or
mental impairment that has a substantial or long-term negative effect on his or her ability to
do normal daily activities; this also includes progressive illnesses (GOV.UK, n.d.). The countries
of Great Britain (Wales, England, and Scotland) developed a national policy called the Equality
Act 2010, which the Office for Disability Issues by the British government administers. The
term impairment is described systematically by the British government and includes a section
that clearly acknowledges invisible illnesses as causing disabilities stating: It is important to
remember that not all impairments are readily identifiable. While some impairments,
particularly visible ones, are easy to identify, there are many which are not so immediately
obvious (Office for Disability Issues, 2010, p. 7). The guide goes on to name specific invisible
illnesses including rheumatoid arthritis, myalgic encephalitis (ME), chronic fatigue syndrome
(CFS), fibromyalgia, depression, schizophrenia, eating disorders, bipolar affective disorders,
obsessive compulsive disorders, personality disorders, and some self-harming behaviors (Office
for Disability Issues, 2010, p. 8).

Programs that pay disability benefits in Great Britain

include Disability Living Allowance for children, Personal Independence Payment (formally

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called disability living allowance) for individuals aged 16-64, Attendance Allowance for people
aged 65 and over, Employment and Support Allowance for those unable to work due to a
disability, and Carers Allowance, which is extra money to help one look after someone with a
substantial disability. Additionally, there is income support and working tax credit for people
who are low-income earners. In December 2011, the British government reported that
approximately 3,202,910 people received disability living allowances, which represents about
5.2% of the total population of Great Britain. This equates to about 3.3 times the amount of
people that receive disability benefits in the U.S.

The

Australian Institute of Health and Welfare defines a person as disabled if he or she has one or
more of 17 identified limitations, restrictions, or impairments, which have lasted or are likely to
last for a period of six months or more, and which restrict his or her everyday activities.
Australias national policy is called The Disability Discrimination Act 1992, which was passed to
address disability issues across the continent. Australias Department of Family and Community
Services oversees Social Security, housing, and family issues, in addition to the supports for
persons with disabilities (Clayton & Honeycutt, 2005). Additionally, The Office for Disability
Issues and The National Disability Agreement provide employment support for persons with
disabilities (Australian Bureau of Statistics, 2012). The Australian government clearly
acknowledges and defines invisible illnesses within the definition of disabled. The national
programs that pay disability benefits in Australia include the Disability Support Pension and
National Disability Insurance Scheme. Australias disability programs are based on a social
assistance or welfare model rather than social insurance. When compared with countries across
the globe, Australia emerged with the highest ranking for both its overall Social Security system
and disability benefit programs (Clayton & Honeycutt, 2005). In December 2009, the Australian

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government reported that a total of 4,026,200 people were disabled (about 18.5% of the
population), and 2,200,000 people received disability support pensions or benefits, which
represents about 10.3% of the total population of Australia. This equates to over 6.4 times the
amount of people that receive disability benefits in the U.S.
Japan first addressed welfare services for people with disabilities after World War
II when the Law for the Welfare of Physically Disabled Persons of 1949 was passed (Okuno,
1998). Since then, the Japanese government enacted many laws and has formulated many
programs and plans to promote the measures for persons with disabilities. The Japanese
government defines disabled persons as, Persons whose daily life in society is substantially
limited over the long term due to a physical disability, mental retardation or mental disability
(Okuno, 1998, 5). Japan has very limited definitions of disabilities that include motor
dysfunction, visual disability, hearing and speech disability, or internal organ disorder. Although
invisible illnesses can sometimes include motor dysfunction, the Japanese government further
subcategorizes motor dysfunctions into loss of function and amputations only. Mental illness
was the only invisible illness that could be identified based on the programs definitions of
disabilities (Rajnes, 2010).
Japans national policy is called Disabled Persons' Fundamental Law, which was
passed in 1993 to address disability issues across the country. Although it is similar in some
respects to the U.S. SSI program, provisions covering the permanently disabled population in
Japan and the United States are significantly different, including eligibility rules, benefit
calculation, claims and appeals procedures, and access to short-term disability benefits (Rajnes,
2010). Pension benefits under social insurance are provided by a two-tier system in Japan. Any
resident in Japan who is between 20 and 59 years of age is required to enroll in the National

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Pension (NP) program, which provides flat-rate basic pension benefits and collects flatrate contributions from the self-employed and nonworking spouses and students. In addition,
there is the Employees' Pension Insurance (EPI) program for general employees in the private
sector and the Mutual Aid Associations for employees in the public sector. These programs pay
benefits based on how much money an individual pays into the system, which increases with
higher incomes. A significant difference between Japan and other countries disability benefits is
that covered individuals can receive permanent disability benefits once they establish that they
have long-term impairments or limitations in daily living, not limitations in their ability to work.
The U.S., Great Britain, and Australia all consider the persons ability to work when calculating
benefits. Another difference between the Japanese and American programs is that although
Japans EPI program has a higher tax rate than the U.S. program, the maximum tax that can be
collected is about $2700 per month less. In December 2001, the Japanese government reported
that a total of 6,500,000 people were disabled (about 5.1% of the population) and 2,200,000
people received disability support pensions or benefits, which represents less than 1.3% of the
total population of Japan. This equates to about 0.81 times the amount of people that receive
disability benefits in the U.S.
Stigma over mental illnesses is less evident in Asian and African countries than
westernized ones. Fabrega (1991) suggests that the lack of differentiation between psychiatric
and non-psychiatric illness in non-Western medical traditions is an important factor. In Japan,
benefits are less common and more strictly defined but are given to people based on how their
disabilities affect their everyday lives in society, not based on their ability to work. The
relationship between an individual and society overall is valued in Japan and losing ones ability
to be part of and participate in the greater society is what makes one disabled. In other countries

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(including the U.S.), an individuals relationship to society is defined around contribution to the
workplace. Although many invisible illnesses do not seem to be formally recognized either
medically or culturally in Japan, the Japanese acknowledge that invisible illnesses exist.
Although stigma still exists for invisible illnesses in Great Britain and Australia, these countries
include specific descriptions of many of these disorders in their disability programs. By doing
so, they acknowledge invisible illnesses as legitimate and provide more benefits to their citizens
with these conditions as a result.
Social Perception
Many people have strong opinions about public assistance programs such as SSI, and
even Social Security is highly criticized. The American public often does not mind helping a
blind child or an adult in a wheelchair, but they often have difficulty financially helping someone
with an invisible illness. There is much stigma associated with invisible illnesses, and even more
misconceptions about the people who have them. People often do not believe in matters that
they cannot see, and they certainly may fear subjects that they do not understand. Many studies
have found that media and entertainment industry play a key role in shaping public opinions
about mental health and invisible illnesses (Canadian Mental Health Association, 2013). The
media often portrays people with mental health conditions as dangerous, violent, and
unpredictable, while those with illnesses like chronic fatigue syndrome or hypochondria as
attention seekers. News stories that sensationalize violent acts by a person with a mental health
condition are featured as headline news, while there are fewer articles that feature stories of
recovery or positive news concerning similar individuals. Entertainment frequently features
negative images and stereotypes about mental health conditions, and these portrayals have been
strongly linked to the development of fears and misunderstanding. People often use stereotypes

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about mental health conditions to justify bullying. Some individuals have been denied adequate
housing, health insurance, and jobs due to their history of mental illnesses. Due to the stigma
associated with these conditions, many people have found that they lose their self-esteem and
have difficulty making friends. Many individuals who suspect that they might have a mental
health condition are often unwilling to seek professional help due to the social stigma and fear of
what others may think. These negative perceptions influence policy development and keep
people with invisible illnesses from receiving the benefits that they desperately need.
The Americans with Disabilities Act of 1990 was the first significant law that
provided civil rights protection for persons with disabilities (Segal, 2013, p. 158). The main goal
of the law is to ensure changes to the workplace so that persons with disabilities can apply for
jobs, perform job functions, and have equal access to benefits available to others in the
workplace. This law, however, is often more helpful for those with physical disabilities, as these
individuals have further obvious conditions that are generally less costly or complex. Americans
do not like paying taxes, and since taxes fund disability programs, Americans are very particular
about how their money is spent. The American public perceives the impact of invisible illnesses
as inferior to the affects of physical disabilities and therefore demands that the government put
their time and money in policies and programs that will influence the people who are
obviously disabled and need the help. Policy and decision makers in the U.S. follow the will
of the people, and the majority does not understand what invisible illnesses are or how they
actually influence peoples lives.
In October 2013, about 8,936,000 workers with disabilities received disability benefits
from OASDI (Social Security Administration, n.d). In addition, there were 157,000 spouses of
workers with disabilities and 1,871,000 children of workers with disabilities who received

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benefits. Approximately 8,381,000 people received SSI benefits in October 2013. Of those
beneficiaries, 1,317, 000, (or 15.7%) were 17 years old or younger; 4,955,000 (or 59.1%) were
between 18 and 65 years of age; and 2,109,000 (or 25.2%) were over the age of 65. About 55%
of beneficiaries were women; 61.1% of recipients were white; 17.2% were black; 12.3% were
Hispanic; and 9.4% were of another race. The U.S. defines disabilities by diagnosis. In 2012,
4% of beneficiaries had nutritional or endocrine disorders; 6% had intellectual disabilities; 8%
had circulatory issues; 9% had nervous system impairments; 28% had mental disorders; 32% had
musculoskeletal and connective tissue issues; and 17% had other impairments (Social Security
Administration, n.d.). With percents distributed by vague diagnoses, it is impossible to
determine what percent of people receiving disability benefits have invisible illnesses.
My Personal Beliefs
Cultural and social beliefs often shape and perpetuate the negative
perceptions of people with disabilities (Appleby, Colon, & Hamilton, 2011, p. 189). There are
many stereotypes and social resistances in American culture, so even today persons with
disabilities are perceived as different from normal people. People who suffer from invisible
illnesses have chronic issues that generally become worse over time. These people often suffer
in silence and become hopeless if they are unable to take care of themselves or provide for their
families.

The responsibility for help ultimately relies on the individual. A

person suffering from a chronic illness must acknowledge the problem and find a physician who
is able to make an accurate diagnosis. An individual with a chronic condition must also advocate
and educate the public about invisible illnesses. The public has a responsibility to be supportive
of policies that will assist people with chronic conditions. Since the public essentially creates
governmental policy in the U.S., the first step to improving the situation is to educate people

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about the seriousness of invisible illnesses. Additionally, the public should advocate and educate
others about these conditions through the media (e.g. blogging or making YouTube videos). This
will decrease the stigma associated with chronic illnesses and encourage medical professionals to
put pressure on policymakers to develop a more thorough system of defining disability.
Eventually, with enough public support, governmental policies will change, and programs like
OASDI and SSI will be modified to provide much needed support and benefits to those with
invisible illnesses.
The United States can use other countries disability programs as models for making
improvements to OASDI and SSI. Australia and Great Britain both use precise definitions of
chronic illnesses to determine their residents disability benefits. As a result, both nations have
been able to provide benefits to more residents with disabilities at a lower cost. The Japanese
system provides disability benefits to less people than the U.S; however, it spends significantly
less in tax dollars and has a more accepting and helpful culture.

Values & Ethics

There are many social work values and ethics that relate to providing services for
individuals with invisible illnesses. Service, social justice, and dignity and worth of the person
are three of the social work values that are critical in servicing those with chronic illnesses.
A social workers primary goal is related to service itself (National Association of Social
Workers, 2008). An individual who is unable to work as a result of an invisible illness relies on a
social workers knowledge, skills, and values in order to help the individual find the appropriate
social programs and resources available to help him or her.
Individuals with invisible illnesses deal with stigma, prejudice, and discrimination from

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the public as well as by the government. OASDI and SSI disability programs do not provide
enough benefits to those afflicted with chronic illnesses. Social workers are advocates of social
change and are committed to social justice and helping people in need, as well as challenging
any inequities that people with invisible illnesses may face (National Association of Social
Workers, 2008). Social workers should also focus their efforts on ensuring that their clients have
access to the disability resources, services, and information that they need.
Finally, social workers always preserve the dignity and worth of the people that they
serve (National Association of Social Workers, 2008). A person who is facing discrimination due
to a chronic condition especially appreciates this value. People who are challenged with chronic
illnesses are often misunderstood and ridiculed by society. A social worker should be mindful of
the clients physical and emotional state and preserve his or her dignity while addressing the
persons need to change and be more responsible. The social worker must acknowledge that the
public may reject the idea that invisible illnesses really exist and encourage the client to
understand that position while preserving his or her feelings of self-worth.

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References
Appleby, G. A., Colon, E., & Hamilton, J. (2011). Diversity, oppression, and social
functioning: Person-in-Environment assessment and intervention (3rd ed.). Boston,
MA: Allyn & Bacon, Pearson Education, Inc.
Australian Bureau of Statistics. (2012). Disability and work. Retrieved from
http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Main+Features40March+
Quarter+2012#intro
Australian Institute of Health and Welfare. (2013). Definition of disability. Retrieved from
http://www.aihw.gov.au/definition-of-disability/
Canadian Mental Health Association. (2013). Stigma and discrimination. Retrieved from
http://ontario.cmha.ca/mental-health/mental-health-conditions/stigma-and-discrimination/
Clayton, A., & Honeycutt, T. (2005, June). Disability benefit systems in Australia. In Learning
from others: Temporary and partial disability programs in nine countries (pp. 100-118).
New Brunswick, NJ: Program for Disability Research.
Corrigan, P. W., & Watson, A. C. (2002, February). Understanding the impact of stigma on
people with mental illness. World Psychiatry, 1(1), 16-20. Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832/#B26
Fabrega, H. (1991). Psychiatric stigma in non-Western societies. Compr Psychiatry, 32, 534551.
Fibromyalgia Symptoms. (2013). The history of fibromyalgia. Retrieved from
http://www.fibromyalgia-symptoms.org/fibromyalgia-history.html
GOV.UK. (n.d.). Financial help if youre disabled. Retrieved from https://www.gov.uk/
financial-help-disabled/overview

SERVICES FOR INDIVIDUALS WITH INVISIBLE ILLNESSES

20

Invisible Illness Awareness Week. (2013). Information and statistics about invisible illnesses
and visible diseases. Retrieved from http://invisibleillnessweek.com/mediatoolkit/statistics/
Kearney, J. R. (2006, August). Social Security and the "D" in OASDI: The history of a federal
program insuring earners against disability. Social Security Bulletin, 66(3). Retrieved
from http://www.ssa.gov/policy/docs/ssb/v66n3/v66n3p1.html
National Association of Social Workers. (2008). Code of Ethics of the National Association of
Social Workers. Retrieved from http://www.socialworkers.org/pubs/code/code.asp
Office for Disability Issues. (2010, August). Equality Act 2010: Guidance. London, UK:
Crown.
Okuno, E. (1998, September). Disability statistics in Japan. Asia and Pacific Journal on
Disability, 1(3). Retrieved from http://www.dinf.ne.jp/doc/english/asia/resource/z00ap/
003/z00ap00309.html
Porter, R. (2002). Madness: A brief history. New York, NY: Oxford University Press.
Rajnes, D. (2010). Permanent disability social insurance programs in Japan. Social Security
Bulletin, 70(1), 61-84. Retrieved from http://www.ssa.gov/policy/docs/ssb/v70n1/ssbv70n1.pdf
Segal, E. A. (2013). Social welfare policy and social programs: A values perspective (3rd ed.).
Belmont, CA: Brooks/Cole, Cengage Learning.
Selak, J. H., & Overman, S. S. (2013). You dont look sick! Living well with invisible chronic
illness (2nd ed.). New York, NY: Demos Medical Publishing.
Social Security Administration. (n.d.). Disability planner: What we mean by disability.

SERVICES FOR INDIVIDUALS WITH INVISIBLE ILLNESSES

21

Retrieved from http://www.ssa.gov/dibplan/dqualify4.htm

Social Security Administration. (n.d.). Official Social Security website.
Retrieved from

http://www.ssa.gov/

Soule, C. E. (1984). Disability income insurance: The unique risk. Homewood, IL: Dow JonesIrwin.
U. S. Department of Health & Human Services. (n.d.). Office on disability. Retrieved from
http://www.hhs.gov/od/about/fact_sheets/whatisdisability.html
United States Census Bureau. (2013). Nearly 1 in 5 people have a disability in the
U.S. Retrieved from http://www.census.gov/newsroom/releases/archives/miscellaneous/
cb12-134.html
University of Washington. (2013). History and current trends regarding people with
disabilities. Retrieved from http://www.washington.edu/doit/Mentor/history.html