It seemed so minor — a box slipped from Rita Ray's hand at the office. But 25 years later, she is still struggling with the consequences of the slip that tore a muscle in her hand, "destroyed" a tendon in her arm and forced her to undergo 14 surgeries.

"When they told me I couldn't go back to work I was upset," Ray, 65, said. "I loved working. It was my main goal in life."

Now she relies on the Social Security Disability Insurance program and is a part-time receptionist at a nonprofit in Walker, one of the few jobs in the small town on Leech Lake that she said will accommodate her needs.

The number of people like Ray turning to the disability fund has grown as aging baby boomers become more prone to injuries. The dependence on Social Security Disability Insurance is most acute in a handful of northern Minnesota counties, where desk jobs are scarce and construction, logging and mining take a heavy toll on workers' bodies. Approximately 1 in every 12 residents of such counties as Cass and Koochiching receive the disability benefits, more than twice the state average of 1 in every 25 people.

In graying small towns in rural Minnesota, the federal assistance program — which is financially unstable and recently required an infusion of cash from another Social Security fund — has become more important not only for residents, but for the local businesses where they spend their money.

"This is what you use to buy your groceries, buy your gas, buy that TV set," said Ross Wagner, Aitkin County's economic development coordinator. "It's definitely a ripple effect."

Increased demand

When young people leave Minnesota cabin country for college, they tend not to move back, Dave Kellogg said as he flipped sausage patties and eggs in the kitchen of Jimmy's Family Restaurant in Walker. His daughters live in Minneapolis.

"There's nothing," when it comes to jobs for them in town, he said, shaking his head. "I'd go where I can make something happen."

As the average age of the area's population ticks up, more of the workforce is at a higher risk of injury and disability. That trend is occurring across the country, increasing the demand for disability insurance, said Kathy Ruffing, who has studied the disability insurance program at the Center on Budget and Policy Priorities.

Two other factors contribute to the growing reliance on the program, she said: The age at which people can get full Social Security benefits has gone up, causing people to turn to disability assistance in the interim, and more women have entered the workforce, increasing the number of potential recipients of SSDI.

As demographics shift, the growth is starting to slow, Social Security Administration spokesman Doug Nguyen said. But in Minnesota the administration's data shows a continual increase in the number of people relying on disability insurance. In 2014, 146,805 disabled Minnesotans received the benefit, up from 81,035 people in 2000.

To participate in the program, people must prove they are disabled. They also need to have worked for a certain period of time and have paid Social Security taxes. In 2014, the median monthly benefit for a disabled worker in Minnesota was $1,068.90.

About 4 percent of Minnesotans between ages 18 and 64 get Social Security Disability Insurance — the 16th lowest percentage of recipients of any state in the nation. Ruffing said that may be due, in part, to the state's comparatively educated workforce. People with higher educations have a better chance of securing desks job that accommodate physical disabilities, she said.

Source: Social Security Administration

A looming shortfall

For individuals and communities that rely on disability insurance, the benefits come with uncertainty.

The trust fund that pays for the federal program, which is funded by payroll taxes, was shrinking with growing demand and set to run out of cash at the end of 2016. Across the country people could have seen a 19 percent cut in their benefits.

Then, last October, Congress and the White House reached a budget deal that included borrowing from another Social Security program to temporarily shore up disability assistance.

The bipartisan bill included provisions to help improve the solvency of the disability program, such as the expansion of the investigation units that look into suspicious disability claims, Nguyen said. When the budget bill was passed, House Majority Whip Steve Scalise, R-La., said the reforms are important to protect the disabled and "to prevent people from abusing that program, from the double-dipping and fraud involved in that program."

The budget act only provided enough money to fully fund disability insurance costs for six more years.

Any future cuts would have a significant effect on the economy in Aitkin County, where about 9 percent of people get the benefits, said Wagner, the economic development coordinator.

"One of the best ways to build your economy is through payroll," he said, and a cut to disability benefits is similar to a portion of the population getting a pay cut.

That loss would also be felt along Walker's main commercial drag, said Glynna Stewart, restaurant manager at Village Square Café. If the government cut people's benefits, "going out to eat would be the first thing they quit doing," she said.

Federal cuts would result in more people turning to other aid programs, like food stamps, medical assistance and housing subsidies, said Mary Germscheid, a workforce development director at Goodwill Easter Seals who has worked with disabled people who have benefit questions.

"There will be a lot more expense on the state and local side," Germscheid said. "It's got to come out of somewhere."

Financial balancing act

Disability benefit recipients said while they are thankful their checks were not cut, the assistance they get now is often too little too late.

The roughly two-year application process to get disability insurance — that wait is a result of backlogged claims and not enough judges to handle the caseload, disability attorneys said — can lead to financial ruin for some.

"They probably are going to have used up everything they have" in the meantime, said Lionel Peabody, a Duluth-based disability insurance attorney.

Several recipients said in addition to disability insurance, they need part-time jobs to repay debts and survive. But finding a flexible employer who is willing to work around their bad days or accommodate physical limitations is challenging.

In Walker, Super One Foods grocery store is one of the largest employers, store manager Mark McKenna said. He tries to help people with disabilities, but nearly all of the jobs at the store involve heavy lifting or standing for a long time, he said. They have a couple employees who handle scanning and bookkeeping in a tiny office space.

"We're just very limited," he said of office jobs in town.

At Access North, the disability assistance nonprofit where Rita Ray works, she hears stories from people who have lost their homes because they cannot get benefits or find a manageable job.

"I feel so blessed," Ray said of her ability to make ends meet. "I didn't know that I'd ever work again."

Jessie Van Berkel • 952-746-3280