Senator Rand Paul (R-KY) had to walk back recent comments about Americans who abuse disability benefits after critics attacked his comments, but he was not wrong and new numbers from the Social Security Administration seem to strongly support his claim.

The latest data from the Social Security Administration (SSA) finds that more than 10 million Americans receive disability payments and the top two reasons they apply are because of mental disorders and “musculoskeletal system and connective tissue” problems – i.e. back problems.

Speaking in New Hampshire last week Paul noted:

What I tell people is, if you look like me and you hop out of your truck, you shouldn’t be getting a disability check. Over half of the people on disability are either anxious or their back hurts — join the club. Who doesn’t get a little anxious for work and their back hurts? Everybody over 40 has a back pain. And I am not saying that there are not legitimately people who are disabled. But the people who are the malingerers are the ones taking the money away from the people who are paraplegic, quadriplegic. You know, we all know people who are horrifically disabled and can’t work, but if you have able bodied people taking the money, then there is not enough money for the people who are truly disabled.”

While his critics were quick to attack this trained ophthalmologist and likely 2016 presidential candidate, there is truth to Paul’s comments about the origins of the injuries that drive millions of Americans to seek government benefits.

According to the SSA’s latest report, in 2013 disability payments were made to 10,228,364  people and that’s up 139,625 from 2012 when there were 10,088,739 disabled beneficiaries. The numbers are staggering and have climbed particularly high under the Obama Administration. Disabled beneficiaries have increased 49.7 percent from a decade ago when there were 6,830,714 beneficiaries. From 2009 when President Obama took office until now, that number has jumped 14.3 percent alone (up from 8,945,376 beneficiaries).

Just over 35 percent of beneficiaries (or 3,599,417 people) – the largest group of disabled beneficiaries – last year claimed that a mental disorder precluded them from working. The runner ups were "musculoskeletal system and connective tissue” problems which accounted for 27.7 percent of disability claims (2,829,808). According to SSA website’s list of specific conditions that fall under this category, back pain joins neck pain, fractures of limbs, hernias, ruptured discs, osteoporosis, arthritis, and other conditions. CNS news reports:

The report also examines beneficiaries who have filed for workers’ compensation or public disability benefits. The report finds that the number one diagnosis for those who have filed are because of “musculoskeletal system and connective tissue,” with 59.8% of those who have filed having that diagnosis. The second highest group, or 10.6 percent of those who filed, were diagnosed with a “mood disorder.”

A disabled worker, according to the Social Security Administration (SSA), is a “beneficiary who worked in covered employment long enough to be insured and who had been working recently in covered employment prior to disability onset.”

“Individuals are considered to be disabled only if their physical or mental impairment(s) are of such severity that they are not only unable to do their previous work but cannot–because of their age, education, or work experience–engage in any other kind of substantial gainful activity that exists in the national economy,” says SSA.

So what about the Senator Paul’s claim of people gaming the system? That’s harder to prove. SSA claims that the incidence of fraud is a microscopic less than 1 percent. CNN finds that the number of applications referred to investigators and then the number of cases actually determined to be fraudulent are in the thousands. Before a congressional committee in 2012, a Social Security administrator said that of the 19,000 cases referred for suspected fraud, only about 4,600 were opened for fuller investigation and fewer were determined to be fraudulent.

That sounds nice and tidy, but let’s be realistic here, the process for investigating claims is backlogged and reactionary – not proactive in finding wrongdoers. If you are waiting on cases of fraud to be referred to you, you’ll be waiting for a long time. Human nature says people mind their own business and do you expect scammers to report themselves?

Social security disability is a hot topic in Washington, not just because of Senator Paul’s comments. Republicans are launching an effort to reform the system, which is set to go broke by 2016. Democrats are fearful they are not just out to reform but dismantle the program especially if conservatives keep both Senate and House majorities and take the presidency next year.

The story with Social Security is not over. Perhaps a bigger story is how few people each year get off the payment program because their health and mental well-being improves or their claims fraudulent. Last year that was just 770,000 of the 10 million people receiving SSD benefits.

We have no problem with those with genuinely debilitating physical problems receiving disability, but surely some of these vague complaints would not preclude work. If too many people who could work apply for and receive benefits, the system will someday be in jeopardy for those who really are unable to work.

When people need help, we want to help them, but what about their long-term sustainability? How do we help them get better to help themselves?