Disability Cases Last Longer as Backlog Rises

[shireen]

Source: New York Times

RALEIGH, N.C. — Steadily lengthening delays in the resolution of Social Security disability claims have left hundreds of thousands of people in a kind of purgatory, now waiting as long as three years for a decision.

Two-thirds of those who appeal an initial rejection eventually win their cases.

But in the meantime, more and more people have lost their homes, declared bankruptcy or even died while awaiting an appeals hearing, say lawyers representing claimants and officials of the Social Security Administration, which administers disability benefits for those judged unable to work or who face terminal illness.

The agency’s new plan to hire at least 150 new appeals judges to whittle down the backlog, which has soared to 755,000 from 311,000 in 2000, will require $100 million more than the president requested this year and still more in the future. The plan has been delayed by the standoff between Congress and the White House over domestic appropriations.

Read more: http://www.nytimes.com/2007/12/10/us/10disability.html

---

For an administration that does not believe in evolution, they seem to take a Darwinian approach in social policy ... survival of the fittest.

As usual, the people who can least help and protect themselves, are the victims. Nice going, Republicans! You sure know how to weed 'em out! Jesus would be proud.

[ayeshahaqqiqa]

1. Then my husband was extremely lucky

He won his SSD case the first time and will start getting benefits this month.

[Irishonly]

2. As was my husband

His case worker was shocked it only took three weeks for the approval. I had to fight for three years. When I went to the hearing the judge, after asking a few questions, apologized and look up codes codes. If you ever check out disability message boards most are put through hell before they receive any benefits.

[ayeshahaqqiqa]

8. I'm wondering if it is the ailment that makes the difference

My husband was diagnosed with myasthenia gravis, after two years of trying to figure out what was wrong. He had tests for this run before he applied, and one especially was one with very few, if any, false positives. He had all information ready and faxed to them and got okayed in two months.

[Irishonly]

9. I think medical records being complete may be the key

I suffer from RA. fibro, pn and a few other things. Fibro and PN are hard to diagnose. My poor oncologist finally had to admit the chemo probably triggered the pn and fibro but that was just last year.

My husband was diagnosed with PTSD, severe depressive episodes and bipolar as well as a few others also. Two years ago he found his brother's body. His brother committed suicide on the same day we had a doctor's appointment for him. It forever changed my husband.

We had learned from my experience what not to do. His doctor sent detailed psychological and medical records and the form I filled out for him was bleak. I didn't lie but I sure didn't write down anything he could still do.

Most people don't realize the committee deciding if you are disabled or not is comprised of lay people. Somehow our government thinks lay people are better equipped to decide if you are disabled or not than your doctors.

[ayeshahaqqiqa]

11. the folks at Social Security were impressed

when he came in with all his records, even his original birth certificate. The only thing he hadn't brought was a voided check for automatic deposit.

[Irishonly]

12. I think so

NT

[Kurovski]

20. It also depends on who gets assigned to your case.

Some conditions are political, as was AIDS in the beginning.

While no one is supposed to base a decision on their own opinion, but rather just upon the evidence, that is not always the case.

[happyslug]

18. The biggest issue is age and Education

If you are above 50, and did nothing but heavy labor and it is determined you can no longer do heavy labor, or any work above the Sedentary level you will win. At 55 the cut off is Light work, at 60 Medium work.

Sedentary work, work that requires you to lift no more than 10 pounds.

Light work, work that requires you to be on your feet more than 2 hours in an 8 hour day OR require you to lift 20 pound occasionally and 10 pounds frequently. Most office work is light work (i.e. you have to get up and walk files around).

Medium Work, work that requires you to left up to 50 pound occasional, 25 pounds frequently. Your Local Super market Check out girl does Medium Work.

Education makes more jobs open to you, thus if you have limited education hard to find a light or Sedentary Job.

[SlingBlade]

3. And for those of us who wait

And wait and wait after jumping through every conceivable hoop and medical test designed to cause us to fail the requirements and the response is always the same for those of us who continue on.

We're backed up, And hey. We’ve got some more paper work, Test, opinions etc.

I’ve worked for over thirty seven years and after a construction accident with a broken back and other ailments they make me feel like freeloader even though I’ve paid in the entire time.

This is a joke and a manipulation.

[shireen]

4. i'm so sorry to hear that, hope you're doing OK....

The article made me real angry. I wonder if the Bush government realizes that they're messing around with peoples' lives! Probably not, or they would not allow the SS offices to be so understaffed. This is a vital service for all US citizens. We've paid taxes to ensure that our fellow citizens have some sort of safety net, and may someday even need it ourselves. These stories about 3 year delays are sickening.

Anyone know if it was this bad during the Clinton administration?

[SlingBlade]

5. No but I believe the

Bush Misadministration has plenty to do with it.

Most of these clowns including Shrub have never worked a day in their lives.
They wouldn't have a clue what it means to not have a nickel in your pocket
after paying out of pocket cost for meds and office visits.

And I’m one of the lucky ones. My wife's insurance plan kicked in.
Thank God and I really feel for those who don't have that option.

[Irishonly]

7. I believe you are right

I am so sorry you are having to go through this hell. Answering the questions SSDI requires has got to be one of the lowest points of my life. Isn't is amazing that your own government tries its best to make you feel you are too lazy to work? Hang in there, I am pulling for you.:hug:

[Arkansas Granny]

6. According to the article, things have gotten much worse since

2000.

"There are 1,025 judges currently at work, and the wait for an appeals hearing averages more than 500 days, compared with 258 in 2000."

[SlingBlade]

10. Yea I can believe that

We have a forum here, The disability forum.
Want to read some horror stories of what some if us have been going through, That's it.

These are good people and fellow Dems, Progressives and Independents.
Makes your heart break.

To hell with Shrub and this whole damned WingNut administration.

[Kurovski]

22. Three year waits were not unusual during Clinton's admin.

Gore was assigned to streamline the system, but nothing much ever came of that.

If there are more people applying (as the population ages) perhaps that is escalating, or keeping the problem in place.

[silverojo]

27. That's why I don't want Gore to be president, either n/t

[Pastiche423]

25. During the early years of the Clinton Adminstration

it took three months from the day I mailed all of the documentation until I got my 1st check.

I give all of the praise to my doctor who knew how to fill out the forms. (Being paralyzed might have helped out too.)

[silverojo]

26. This is sarcasm, I hope?

I wonder if the Bush government realizes that they're messing around with peoples' lives! Probably not, or they would not allow the SS offices to be so understaffed.

If you're not being sarcastic, then you're terribly naive about how this administration and its feckless leader could care less about people's lives. Particularly the lives of people who are poor AND disabled.

And yes, it was this bad during the Clinton administration. Clinton's the reason people applying for SSI/SSDI can't even get on welfare or even food stamps while they're waiting to get on SS.

Unless you have "dependent children", which is a euphemism for, "If you breed irresponsibly, welfare's all yours; if you're injured or ill and responsible enough NOT to have kids you can't feed, @#$% you!"

This is Reason Number One why I do NOT want another Clinton anywhere near the White House. Bill decimated FDR's New Deal enough, thank you. :grr:

[JPZenger]

13. Everyone Should Buy Private Disability Insurance

This article points out a very serious problem.

For people who are still healthy, I recommend that everyone buy private disability insurance. You cannot depend on social security, and the chances of becoming disabled are rather high. As described above, many persons with serious disabilities suffer long delays before they get benefits.

There are short term and long term policies. A short term policy, for example, would pay you a monthly amount for between 30 days and 1 year after you become disabled. That is intended to help cover the gap between when you apply to social security (after 6 months I believe) and when you might possibly expect approval.

A long term policy could pay you monthly benefits until you reach retirement age.

Some policies pay you in addition to whatever social security might pay, while others deduct whatever you might get from social security from their benefit.

One of the main benefits of private disability insurance is that it pays you if you cannot do your current job. Social security will only pay you if you can't do ANY job.

If you start buying it when you are younger, it stays affordable as you age. The policies I have are fixed price - they can't go up and can't be cancelled as long as you keep paying the premium. Once you have pre-existing conditions, then it becomes very hard to sign up for insurance. Therefore, you need to start buying it when you are healthy.

Some policies are available for a couple hundred dollars a year.

[kickysnana]

15. Everybody needs a steady living wage job to buy such luxuries. n/t

[DemBones DemBones]

29. Not to mention that private disability insurance adjusters are even

less likely to believe a person is disabled; more likely to force you to go in for half a day and sit at a desk doing nothing. People working for the government (police, postal workers, etc.) get disability pay (not SSDI) but have to do the half days at a desk bit. Really great when you're in pain, plus it requires your spouse or someone to drive you to work and come back and pick you up. That's true even when it's a worker comp injury; actually it's especially true of workers comp injuries. So you're a cop who got injured chasing a felon? Too bad for you.

I'm sure some people scam disability claims but why I don't know. Who would want to stay at home for $700-$1000 a month that SSDI pays when they were earning several times that amount?

[KamaAina]

14. If they would just stop saying "No" automatically

they wouldn't need "150 new appeals judges to whittle down the backlog". Mooks.

[lildreamer316]

16. ! May I quote you?

"For an administration that does not believe in evolution, they seem to take a Darwinian approach in social policy ... survival of the fittest."

LOVE. IT.

[Kurovski]

17. Three years? pffft!

Someone close to me had to fight for nine years. And knew of two others who waited 6 and seven years.

The terrible thing is they were granted benefits immediately and someone in the system interfered with the decision. In the end the paperwork amounted to the size of a Chicago phone book.

They're like an insurance company that does NOT want to pay out. This creates many jobs for lawyers and doctors who are doing the testing and show up for the many hearings involved. I wonder how many millions are wasted each year on all of the paper work alone.

[Faygo Kid]

19. What kind of people are we to accept this? What if it was your mother or brother?

We can flush $3 billion a week down this toilet of a war, but we can't come up with $100 million just to keep pace with the existing backlog? These are, as many have posted here, real people in real need who our nation has promised to help, and yet we fail to provide that help.

This is disgusting. My nominee for underreported story most appropriate at Christmas time.

[Kurovski]

21. If it is someone you know and they're out of funds,

you'd best be prepared to lend some assistance.

This "three year wait" is NOT new. It has been going on for a DECADE.

I may even have a Sun-Times article in my clip file from seven years ago saying the same about a three year wait then.

[hyphenate]

23. It took them a year and a half for me

to get approved. I was scheduled for a hearing, but the administrative law judge made a decision before the hearing itself, based on all the evidence. My sister in law is terminal, and it still took longer than mine. I had a law office handling my case which helped, because I wasn't able to do much on my own behalf.

It gets very difficult to handle the whole thing, and I can see why people quit. I almost gave up personally. But I was trying to live on $300 a month, and that wasn't easy. Even now, there are few luxuries, but I can pay all my bills at the beginning of the month and that alone helps.

[hollowdweller]

24. Please Read This!

First concerning the aquisition of medical and denials on the first two levels:

If a claimant submits their own medical and it contains the required documentation that shows that the claimant meets the listings the wait is VERY short. If most people had the time they'd be way ahead to just go to all their sources and get the medical to submit with their claims.

Also on people over the age of 55 who cannot do their past work it is VERY important that they fill out the report of the jobs they did and all of their duties as fully as possible. If a person does not meet the listings and they are over 55 there are special rules that allow DDS to sometimes allow these people if they do not have any transferable skills to a lighter work are over 55.

However say the disability caseworker requests the info and it takes the persons treating source 2 months to send the info in. Then it is nothing but illegible hand written scribbles. Then the examiner must schedule an exam. It can take anywhere from a few weeks to a month to get a date and then a few weeks to a month (or more) to get the source to send the report to DDS. Then it has to undergo medical review which can take a few days to a few months depending on the examiners caseload and the backlog for for the medical consultants who review them.

Also there is some evidence like heart catherizations, school records or psych treatment records to back up mental allegations that are impossible for SS to buy exams to replace and it can take months sometimes to cajole these sources into responding.

As far as the backlog for ALJ hearings there has always been a backlog. More judges are a first step. However the same thing that makes that process slow makes it more favorable to the claimant.

The rules that the DDS examiners and doctors who review the claims under are very strict. Also they make it harder to allow a claimant who perhaps has multiple severe impairments, but these impairments by themselves do not meet any specific listing. Also after the decision cases adjudicated by the DDS are subject to both an internal QA review and a federal regional quality review where "iffy" cases may be kicked back for more documentation or a reversal of decision. In addition those processing cases at the DDS level are under pretty tight production and mean processing time quotas.

By contrast the ALJ's are not held to as strict production or processing time standards. Also while some of their decisions are reviewed by the Appeals Council there is not the oversight on their decisions that the cases in the DDS receive, and they use this along with the extra time they have due to the lack of strict production standards to often interpret the law in such ways that they allow people that the DDS would never be able to allow with out their QA kicking them back.

Also remember that just a diagnosis is not enough to be allowed on. Most of the disability regulations in SSA's listing of Impairments have criteria that relates to functioning that must be met. A lot of times doctors do not fully address this in their reports. Besides getting your medical records to submit often it is helpful to get your doctor to write a letter on your behalf laying out in detail the things your condition prevents you from doing mentioning the physical findings to support it.

If you want to make sure you get the proper info related to your impairment that DDS needs on the first two levels you can go to the Listings of Impairments on the SSA website and it has the criteria for being found disabled that SSA uses.

http://www.socialsecurity.gov/disability/professionals/bluebook/AdultListings.htm

Remember at least at the DDS levels there is less paperwork involved in allowing a claim than denying one so most people working claims will be looking to see if there is any way the claimants case can be allowed. It won't hurt after you have filed your claim to call your worker and ask if there is anything they might need that might help your claim that you could go get.

Hope this helps.

[LittleWoman]

28. This is excellent advice and I would only add one thing

when you get your hearing date be sure to show up at least 30 minutes before the time of the hearing. If you do not have an attorney you will need time to look over your file and if you do have an attorney he/she may want to speak with you before the hearing.

If you are not sure of the exact location of the hearing office get the information you need to get there before the day of the hearing. Call the office and ask for directions and make sure you understand them. Do not show up late with a lame excuse as the chances are that your case will be dismissed. You will have waited a long time for your hearing and this is your only chance to make your case before an administrative law judge, don't waste the opportunity.

I emphasize this last because there are a number of individuals who do not show up for their hearings and not only does their case not get heard but the time slot is wasted and there are many who would be happy to take their place.