Social Security
Sick of Waiting
The number of claims for Social Security disability payments has doubled since 2001.
It can take years for a case to be reviewed.
Meanwhile, applicants struggle to survive.
By Barbara Basler
November 2007
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Maria Leal of Portland, Ore., tells her story slowly because her tongue is sutured, making it difficult for her to speak clearly. She has grand mal seizures, and during the last one she bit down on her tongue so violently it needed stitches.
For 25 years, Leal, 53, was a dental assistant, but recently, even though she takes medication, her seizures began to interfere with her job. Too sick to work, she applied for Social Security disability insurance, which working Americans automatically pay for through payroll taxes and are entitled to collect if they become too ill or disabled to work.
But three years after she applied for disability benefits, Leal is living in a residence for the homeless, sharing a bathroom with 54 other women and eating baloney sandwiches. She's still waiting for her claim to be processed.
"I haven't worked since 2004, and I have no money," she says. "I've lost my apartment and my car. Just to finally get a hearing would be a precious gift."
Today the Social Security Administration (SSA) faces a record backlog of disability cases like Leal's, with 750,000 vulnerable people waiting?some for years?for a hearing and growing more desperate each day.
"People have died waiting for a hearing," Social Security Commissioner Michael Astrue concedes. "This is America, and it is simply not acceptable for Americans to wait years for a final decision on a claim."
Disability claims, officials say, have doubled since 2001 as millions of boomers in their 50s?the years when working men and women are most prone to illness and disabilities?have applied to collect the insurance. Despite a growing aging population and caseload, the agency hasn't been able to afford to add workers. Congress has consistently cut the SSA's budget requests since 2001, leaving the agency's overall staffing at its lowest level in 34 years.
Budget limitations, staff reductions and a growing list of new duties?from processing Medicare applications to a raft of homeland security rules governing issuance or replacement of Social Security cards?are taking a toll on Social Security offices across the country. In some offices calls go unanswered and people wait in long lines for service.
But the SSA's 51-year-old disability benefits program has the most pernicious delays, with people now waiting an average of 520 days for a hearing on a claim.
The wait in Atlanta, with one of the worst backlogs, averages about 900 days, almost three years. In Portland, where Leal lives, the wait is nearly two years, says Richard Sly, an attorney there who has handled disability cases for 30 years.
"By the time you request a hearing," says Sly, "you've already spent at least three to six months in the process, often a year. Then it's running another two years. I get angry just talking about this."
An estimated 8.7 million people are currently receiving disability benefits, with monthly payments for disabled workers averaging $979. This year 2.5 million people have applied for benefits, a figure expected to grow by 90,000 each year for the next five years.
Because disability cases can be complex and the medical and work records extensive, two out of three people who apply for benefits each year are initially rejected. On appeal, cases are heard by an administrative law judge trained to review these files, and more than 60 percent of those claims are approved.
At the hearing stage, about 50 percent of those making claims hire a lawyer to help them navigate the process. Legal fees are capped at $5,300 by federal law, and due only if and when the client collects disability payments.
Linda Fullerton of Rochester, N.Y., a former computer purchasing agent, fought for her benefits for more than two years after she developed a brain abscess that required surgery and led to a constellation of problems, from joint disease to chronic muscle pain. "I was finally approved," says the 51-year-old, "but by then I had lost all my pension money and run through my savings."
"You think once you get the disability money, you'll be OK," she adds. "But you never recover financially. I have no financial security."
Disability, Fullerton says, "is not a handout. This is insurance that we have paid for, and we just want to collect on the policy."
Fullerton was so incensed by her experience that she formed the Social Security Disability Coalition, a grassroots online group in which people who have been through the process try to help those struggling with it.
"This whole situation is tragic," said Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, which has called for a $430 million increase in SSA's appropriation for 2008. But it's likely that Congress will approve an increase of only $120 million to $125 million.
With the smaller increase?which would be spread across the entire agency, including field offices?SSA would have "limited resources to use to drive down the hearings backlog," says Astrue, the SSA commissioner. SSA would be able to add no more than 150 of the 185 judges it needs, he says. Currently, 1,065 judges carry an average annual workload of 680 cases.
It takes more than a year, however, to train a hearings judge, Astrue says, "and we won't begin to see a real benefit until 2009."
Advocates say too many compelling disability cases are rejected out of hand, and SSA needs to design a better initial screening process as well as add more judges.
Sly, the Portland disability attorney, says, "No one knows for certain why so many cases are denied, then later approved. I think they tend to reject claims if there are any questions or problems. They're trying to move these cases through the system, and if there's any problem, any question, they deny the claim and move on to the next one."
Astrue points out that one reason more cases are approved on appeal is because people just get sicker as they go through the lengthy disability process: "If this process is delayed, their impairments sometimes become more severe, resulting in a favorable decision," he told members of a congressional committee.
To improve the process, Astrue plans to draw up a list of diseases and conditions that should be allowed on diagnosis alone, such as acute leukemia. He wants to hold more hearings for people in remote areas through videoconferencing and to send judges temporarily to areas where the backlogs are the worst. But the changes will take time.
Even with adequate funding and his "aggressive plans" for streamlining the process, Astrue says, the hearings backlog will not be eliminated until 2013.
Meanwhile, Maria Leal's life is centered on a secondhand black plastic briefcase, where she keeps the medical records for her case.
"Two doctors certified me 100 percent disabled, but I was rejected twice," says Leal, who not only has seizures but also has been diagnosed with rheumatoid arthritis, fibromyalgia and pancreatitis.
Still self-conscious about her sutured tongue, Leal says carefully, "Can you understand what I'm saying? Please tell me, can you understand?"
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