26

Disability claimants wait ... and wait

Social Security cards

To view this content, Javascript must be enabled and Adobe Flash Player must be installed.

Get Adobe Flash player

TEXT OF STORY

KAI RYSSDAL: Here's today's Marketplace trivia question. The first one to get it right -- as judged by the time stamp on the e-mail -- gets my voice on their home answering machine. What's the official name of Social Security?

I'll take a beat here while you think. If you need a hint, the acronym is OASDI -- old age, survivors and disability insurance.

Most of us know about the old age and survivors benefits. But there are about 7 million Americans who collect disability benefits from the Social Security Administration every month. Every year, another 2.5 million people apply.

Which brings us to the problem. There's a backlog of 750,000 people trying to prove they deserve those disability payments. Later this month Congress is going to weigh in on what to do about it.

Marketplace's Nancy Marshall-Genzer reports.


MARSHALL GENZER: When the Social Security disability program started, in the 1950s, it was aimed at blue collar workers with obvious injuries. Government newsreels described it this way.

NEWSREEL: Today, a new car comes off the assembly line every 48 seconds. These are the men and women who have Social Security protection, in case sickness or accident causes a disability that is so severe that earning a living is no longer possible.

Today, a lot of people with hard-to-prove illnesses apply for disability benefits. They have Lupus or Chronic Fatigue Syndrome. Social Security sees them as borderline cases. So, they're often denied.

But once applicants get a chance to appeal to a judge, two thirds of them win. If they lose, they can appeal again. That swells the backlog even more.

Judge Robert Habermann hears disability cases in Roanoke, Va., and is an officer in the judge's union. He says the Social Security Administration is pressuring judges to just ram through positive decisions.

ROBERT HABERMANN: It solves a lot of problems by just paying the case. The individual claimant is out of the system. In other words, there are no appeals.

Haberman says those positive decisions could stack up to billions of dollars in wasted taxpayer money.

MICHAEL ASTRUE: Well I've heard that as a union line, but that's just not true.

That's Social Security Commissioner Michael Astrue. Astrue says he can't, and doesn't tell judges how to decide cases. He says the problem is a shortage of judges and very uneven productivity. The Social Security Administration now encourages each of its nearly 1,200 judges to hear 500 to 700 cases per year.

MICHAEL ASTRUE: We've had judges who decided no cases in a year. And we've had judges that have fairly chronically decided double digits -- 40 cases a year.

All told, the judges hear more than a half a million cases per year. But that's not enough to get through the backlog. Astrue wants to up the number of judges and their productivity to eliminate the backlog in about five years.

And Astrue says judges aren't just ramming through positive decisions, either. Forty-six-year-old Karen Ierardi can attest to that. At her hearing this year, a judge denied her disability benefits.

KAREN IERARDI: I just felt that he didn't understand it, what I'd been through. And I don't think he had a lot of knowledge of the disease itself that I had been going through.

Ierardi has rheumatoid arthritis and so she was a borderline case. She had to quit her job as a substitute teacher in a suburb of Richmond, Va. Now she lives with her mother in a cramped apartment.

Ierardi and her mother have racked up thousands of dollars in credit card debt paying for groceries and gas. Ierardi still can't work. She's appealing her denial once again.

So what's the answer? People with difficult cases like Ierardi's want a fair hearing. Judges shouldn't take too long or feel rushed.

Commissioner Astrue has begun hiring more judges. The first group started this month. He's asking Congress for millions of dollars to hire a second batch of judges. But it's an election year. So it's not likely Congress will act anytime soon.

Social Security claimants stuck in the backlog, will just have to wait. And wait. And wait.

In Washington, I'm Nancy Marshall Genzer for Marketplace.

About the author

Nancy Marshall-Genzer is a senior reporter for Marketplace based in Washington, D.C. covering daily news.

Pages

Cris Blakely's picture
Cris Blakely - Sep 28, 2008

I am also among the many waiting for my appeal to work through the system, and yes, I do have a lawyer - from what many have told me who applied and eventually got it years ago - without one, my wait might be considerably even longer - plus, the frustration of having to fight and file all the paperwork required initially myself, would have made many of my conditions much worse.

That being said - the one thing I cannot fathom is this - the government complains that the reason they deny so many cases(as everyone knows, in many cases folks with terminal diseases may die waiting - and I have heard of some folks with various mental and physical illnesses becoming so depressed, they have committed suicide while waiting)is that - to pay more of them - even the ones that are somewhat obvious - would break the system!

As we all know, many many people die prior to collecting one cent of Social Security, either retirement or SSDI - my late husband died at the age of 50, and no one will ever get the money that was in his account - as one example. I can, once approved, choose to receive his OR mine, but not both as we all know. Had I not worked, I could have received his once I reached retirement age.

In my case, I am only 3 years from early retirement, and applied for SSDI about a year ago initially. In Georgia, the wait, once a case goes into the first appeal for a court date - is approximately 20 to 25 months currently.

As you all know again, those of us that
have some funds, will completely use all of that up, and probably have to incur some debt as well in order to continue our medications and insurance. My insurance alone is almost 600 a month. I have one drug that costs almost 1500 a month, and I am on about 13 different prescription medications.

The insurance has a big deductible, and even once that is over, they only reimburse me for 70 per cent of the cost of whatever I have done or have prescriptions for. While this is better, much better than nothing - and certainly makes the cost of the insurance worth it - I still incur a couple of thousand dollars in medical copays a month.

I was, because of the horrible housing market, unable to sell my home - without my husband, and me being unable to work - I can no longer afford to live here, and was hoping to sell it and find a much less expensive and smaller place to live in.

All the years we both worked and I may ultimately lose the ability to purchase a home of any kind, and wind up in a small apartment. I know I am much better off than many others, but still, losing so much after both of us working about 35 years is still a tough pill to swallow.

I don't understand how the SS offices can say that they would not be able to pay everyone or at least more people that apply! Both my husband and I paid INTO SS all the 35 years we worked, so, I do not feel that this is a government handout. I also feel that whatever money people like my husband and many others who died before their time put into it - should be more than enough to pay for those that were unable to work as many years as we did, or children who might never be able to work at all.

What do they do with the money that is in the system but not collected by the person who put it in if not use it for those that do not have an account?? And how do they get away with saying it is taxpayer money? I paid taxes of course too, but the FICA I was under the impression was for retirement and SS.

If congress is going to have a hearing soon, is there a petition out there that any or all of us can sign - or a number to call our representatives to urge them to act in the interest of those of us trapped in the system??

Thanks!!!

renee curran's picture
renee curran - Sep 22, 2008

I have definately suffered from major depression since I was in high school I spent 2 years in the twelfth grade simply because I missed too many days because I felt so down I couldn't drag myself out of bed till about two in the afternoon after going to bed about ten at night I had an alcoholic father who beat my mom a lot and verbally abused me daily I saw counselors in high school also psychologist and no one wanted me on meds that young when I was 22 after having two kids I saw a psychiatrist and I got on meds I went through several jobs always missing too much work and quitting before I would probably get fired meds would sometimes work for months elevating my mood and then wear off even after I was on highest dose possible so for the past 18years I've been off and on all meds imaginable gained a shitload of weight have suicide thoughts often but I try to stay alive because I know my kids need me three years ago I was diagnosed with bipolar depression took a shitload full of meds up until last December made me very groggy gain more weight and also wore off again I also have 3 herniated discs in my lower back how more depressing could that be I just quit taking methodone for my pain 2 months ago because of chest pain I have a back appointment end of September I guess to get more pain meds because chest pains supposedly is acid reflux it took me 3years to get disability long years I don't know when my review is maybe a couple of years but I got mad at my last psychiatrist and haven't had meds for almost a year and probably need something I want to know will this screw my disability review up I really can't afford a psch anymore and feel meds only temporarily work for me anyway it's hard to hang in there but at least I do have an income now most of the money is spent on my kids lives so they'll enjoy I just worry since I'm not on meds anymore will the judge think I'm okay because I'm really not but I know I couldn't hold a job am I on trouble for next review

renee curran's picture
renee curran - Sep 22, 2008

I have definately suffered from major depression since I was in high school I spent 2 years in the twelfth grade simply because I missed too many days because I felt so down I couldn't drag myself out of bed till about two in the afternoon after going to bed about ten at night I had an alcoholic father who beat my mom a lot and verbally abused me daily I saw counselors in high school also psychologist and no one wanted me on meds that young when I was 22 after having two kids I saw a psychiatrist and I got on meds I went through several jobs always missing too much work and quitting before I would probably get fired meds would sometimes work for months elevating my mood and then wear off even after I was on highest dose possible so for the past 18years I've been off and on all meds imaginable gained a shitload of weight have suicide thoughts often but I try to stay alive because I know my kids need me three years ago I was diagnosed with bipolar depression took a shitload full of meds up until last December made me very groggy gain more weight and also wore off again I also have 3 herniated discs in my lower back how more depressing could that be I just quit taking methodone for my pain 2 months ago because of chest pain I have a back appointment end of September I guess to get more pain meds because chest pains supposedly is acid reflux it took me 3years to get disability long years I don't know when my review is maybe a couple of years but I got mad at my last psychiatrist and haven't had meds for almost a year and probably need something I want to know will this screw my disability review up I really can't afford a psch anymore and feel meds only temporarily work for me anyway it's hard to hang in there but at least I do have an income now most of the money is spent on my kids lives so they'll enjoy I just worry since I'm not on meds anymore will the judge think I'm okay because I'm really not but I know I couldn't hold a job am I on trouble for next review

Gary Lambert's picture
Gary Lambert - Sep 20, 2008

My best friend is currently caught up in this terrible MESS of trying to get disability. He's been at it for 6 years now. He has/had 2 seperate cases before the court. The 2nd was approved first and he got his little bit of back pay and how gets a monthly check. BUT..the 1st case drug on for years before finally ruling in his favor in July of 2008. Isn't it ODD that they said "yes you are disabled" in the 2nd case, but had to go throught all that CRAP to proove his 1st case. The SSA is terribly broken. The right hand doesn't know what the left is doing. But back to what I was getting at. He was notified the 1st of July of 2008, by his lawyer, that his case was ruled in his favor. Weeks went by with no work from SSA. Calling them is totally a waste of time. All they will tell you is "it's in the payment center." By the way..you can't call the payment center..nobody knows their phone number. Well FINALLY about 3 weeks ago he got a long letter from them. They advised they were holding out a certain amount for attorney fees. Also, they wanted to know if he wanted insurance withheld from the back pay. HA! What a joke...he had no insurance benefits during that time so why withhold insurance from the back pay. Also, they were withholding the first 5 months because you have to be disabled for 5 months. Well...when his 2nd case was decided in his favor, they withheld 5 months and now they want to do it again. I think that is double dipping and is totally ridiculous. The case has been in the payment center now for almost 3 months. This is just totally unacceptable. I realize there is a backlog but HIRE MORE PEOPLE to help with the processing. This government of ours is currently doing BAIL OUTS of some financial organizations and doing it overnight. YET...they can't get my friends little bit of money to him which he so desperately needs. I could preach on this for days but to no avail.

Russ Becker's picture
Russ Becker - Sep 16, 2008

Administrative Law Judge (ALJ) Doug Abrazzo has done an excellent job of setting the facts straight as far as the productivity of ALJs. The biggest problem that most of us who represent clients can see is that the ALJs do not have sufficient support staff to prepare cases for hearing and to assist in drafting decisions following hearings. Commissioner Astrue either completely misunderstands the system under him, or he has an agenda to discredit the ALJs to eliminate their independence. Most ALJs are conscientious and work hard to process cases to the extent of their power.
Like ALJ Abrazzo, I am a veteran of the of the Marine Corps, and I have now practiced law for over 19 years. I used to do a general litigation practice doing all of the various types of law which ALJ Arazzo lists in his background. However, I also began doing SSA disability cases because of a prior biomedical background, and it is now about 85% of my practice. ALJ Abrazzo apparently did not do this type of practice, and he lacks any perspective of the work done by attorneys and representatives who appear before him. SSA publishes regulations setting forth the criteria for disability for various impairments to attempt to provide uniformity of decision-making, so claimants with similar medical problems will ideally get the same decison, and it will not be based upon the arbitrary biases of the individual decision-maker. [I do so wish this was more often the case!] The typical claimant has absolutely no concept of the evidence which must be presented to meet these disability criteria and wants to talk only about the pain they suffer. Typically, the claimants dwell on symptoms which are important to them but may not be important to a decision-maker in SSA. The change ALJ Abrazzo sees in the case when the claimant obtains representation occurs if the representative does his/her job because the representative accumulates the correct medical evidence needed to prove the case and will often ensure that the claimant sees a medical specialist who will run the appropriate tests and do needed evaluations. Most people with mental illnesses will "somatize," or complain about physical ailments which aren't the real reason that they are unable to work. An effective representative will get that client into a mental health evaluation and any necessary treatment; then the representative will place the CORRECT focus on those impairments and symptoms from which the claimant suffers which are most important, and not minor ailments about which the claimant originally complained. That is why the case changes, not because of the "boondoggle" which ALJ Abrazzo is concerned about.

Thomas Rivet's picture
Thomas Rivet - Sep 8, 2008

I spent over 5 years in the "system" before I was judged disabled from my original claimed onset date. A huge back pay but woefully inadequate considering what they did to me.
I suffered through the anthrax scare; comms that used to take weeks were taking months all of a sudden.
I was lied to by my ALJ's office.
I was lied to by the ALJ during my hearing and in front of my relatives who were there to help me out.
The ALJ lied and even contradicted himself in the long opines he made in his refusals, he refused to listen to mistakes in my file, refused to listen about data that was missing from my file and in general turned out to be prejudiced against me in my opinion because I put on over 100 lbs from the inactivity of a previously healthy and active lifestyle.
I suffered "lost" forms, one of which was even hand delivered, with a table of contents to my local SS office. There were just too many "losses" of forms to have been coincidences. The last form "lost" on me never would have been discovered at all, IMO, if it had not been for my representative, J McHugh, who insisted on some answers he was not getting from SSA. After that, things began to move along at their regular snail's pace again; once more, too much of a coincidence since my rep was now one of the ones I think were outright lied to. I am of the opinion that the "losses" were intentional and a result of the ALJ's prejudice against me.

After I was awarded disability from my original onset date of 5 years earlier, I submitted a complaint about the judge. On the advice of my lawyer I did not do it sooner because there is a record of ALJ's taking revence of claimaints in this area.
I found out only through the grapevine that the judge apparently received only a slap on the wrist but was still hearing cases I noticed several months later. He even complained during my hearing about how much he hated having to make these trips up here from Syracuse (~120 miles each way). I watched one of his daily routines; he spent approximately 4 1/2 hours in hearings in the motel meeting room and saw two claimants. But I also noticed 4 claimants waiting. I was asked to leave and told not to come back by the motel management.
There have only been two men in my lifetime (not counting military battle duty against the enemy) whom I honestly hated. The other died many years ago. That judge is still alive as far as I know. Apparently my treatment was pretty common; it turned out I was only one of several to submit complaints about him, including accusations of practicing medicine without a license during the hearing.
I was even successfully refused a transcript or copy of the tape recording of my hearing. FOIA did nothing for me; they were a simple black hole and I didn't have the money or the body to pursue it further. Otherwise I probably could have sued the bejeepers out of him and won. I documented nearly every step of the process fortunately and have posted excerpts of it on my web site for others to read.

THAT is what's wrong with the system! It's a damned goold old boy's network and the ALJs know how secure their jobs are and how little work they can get away with and have absolutely no consideration for the claimants in front of them.

If for some strange reason someone decides to contact me about this missive, I seriously recommend not going it by telephone. I have a serious problem with memory retrieval and even give answers and say things I am not aware of and will have no memory of. However, I can work fine with the written word. Thus, e-mail, snail mail, or even facsimile is the best way to communicate with me.

Boy, it felt good to unload that! But my hatred for that ALJ and others like him that I read about almost daily on the disability newsgroup will never dissipate. I'm afraid the only way to save the SS system is with a bull dozer, honestly.

OK, I'm done. It felt really good to vent; it's been a lot of years and I'm still very, very upset over what they did to me.

Dan Dane's picture
Dan Dane - Sep 8, 2008

Don't hold your breath.
The problem at the SSA (disability program) is no different than those of any of the other gov't agencies. The FDIC has examiners and supervisors for years without any real experience in financial institutions. The Immigration Naturalization Service (now homeland security) did not have sufficient funding to even open all of their mail for decades prior to 9/11. The agencies charged with inspecting or enforcing safety standards for imports, food and basic goods and services have been hamstrung for years by a Congress that is only interested in passing laws and enforcing laws that benefit the rich (like pharmeceutical and oil companies) so the rich can pay them bribes and kickbacks.
Our society is charged with caring for the widows and the orphans. In spite of all the rhetoric about this disability program for the poor and the disabled, don't hold your breath for someone in Washington to do anything to fix it. The beneficiaries of this program have no ability to make thousand dollar campaign contributions. This is just another glaring example of our broken government.

Doug Abruzzo's picture
Doug Abruzzo - Sep 6, 2008

I am a Marine combat veteran of Vietnam and I have been a lawyer for more than 23 years. I have represented clients ranging from small corporations to an elected official facing removal for poor decisions, to indigent parents whose children were removed by state authorities, to families torn by a divorce, to auto accident victims and injured workers seeking workers compensation benefits, to criminal defendants. In none of these arenas have I seen more abuse of the legal process than in my last 4 years as a Social Security disability judge. It is a rather classical example of a well-intentioned government program to assist the weakest members of our society transformed into a cash-cow for the avaricious among us. Occasionally - but rarely - do I see a claimant with an entirely fraudulent claim. The clear majority of the claimants who appear before me do have some physical or mental impairment. The real issue is whether that person can meet the definition of "disability" which was intentionally set very high by Congress to provide income to only those whose injuries/illnesses are very debilitating. Unfortunately, that very high bar is approached with deception and falsification in many cases. Some doctors go overboard on diagnoses and treatment because they sense the "pot of gold" in having a fairly young patient (on Medicare for many years to come) with a reliable source of payment for constant treatment. Lawyers and other non-attorney representative can receive fees as a percentage of the back benefits awarded to a claimant. Once a claimant has a legal representative, one can actually track how the alleged impairments become much worse, with new impairments and symptoms added as the case matures. A judge with some experience can almost recite verbatim the same story we hear from virtually EVERY claimant, suggesting they have received training from the national organization of the claimant's attorneys. The government is complicit in this boondoggle, because the Social Security Administration actually publishes lists of symptoms for various impairments in the form of rules for judges to follow. Is it any wonder we hear those lists of symptoms at almost every hearing? For 15 of the past 16 years congress has funded the Social Security disability program at amounts below the amount requested by the president. In the past few years, the growing backlog has been discovered by the mainstream media and suddenly there is a major push to eliminate the backlog. Not a moment too soon, as we are seeing the advance wave of the "baby boomer" generation, those who claim early disability to avoid waiting for their statutory retirement age to come up. Judge Haberman was correct, and Commissioner Astrue was not completely candid in his statement that he doesn't tell judges which way to decide a case. SSA places enormous pressure on the judges to eliminate the backlog by granting benefits to as many claimants as possible. Certainly not by direct means, but by many, many indirect means. Because a judge who denies a claim must provide an extensive explanation for the reasons (and nearly every claimant alleges the symptoms embodied in the published SSA rules) a denial Decision is much more complicated and time-consuming to write, taking 2 to 3 times as long as Decison granting benefits. Yet at one point, Mr. Astrue was threatening job action against any judge who did not meet an arbitraty number of dispositions per year. Mr. Astrue has been a lawyer for a long time; he must certainly be aware that the congress created administrative judges in the Social Security Act and in the Administrative Procedures Act. In those laws, congress specifically forbid administrative agencies (such as SSA) from taking any action against administrative judges on the grounds of their decisons or acts of judicial discretion in managing cases. Just as the framers of the U.S. Constitution divided political powers into three branches to prevent the "political passions of the day" from taking this government down unwise paths, the congress created a form of "separation of powers" between the government agencies and their own administrative judges. Mr. Astrue knows that, but because of the political pressure on him to eliminate the backlog, he is blaming everything on the administrative judges, and deliberately attempting to circumvent the controls congress emplaced for exactly such political circumstances as these at present. Unfortunately, as in most political controversies, Truth is the first casualty. Mr. Astrue speaks loudly and often about the judge who "hasn't held a hearing in X years" or about the "judges who dispose of 40 cases per year." Unfortunately, Mr. Astrue refuses to identify those persons (purportedly because of "privacy issues") and there may be valid reasons for such situations. For example, judges who are appointed to management positons in this agency are stil counted as "judges" even though they may do few -if any - hearings. Judges who are union officials may be involved in extensive litigation against the agency (enforcing the intent of congress against agency behavior) and may spend relatively time disposing of disability cases. We can only speculate because Mr. Astrue will not provide the necessary information to back up his accusations. Finally, some truth may be discovered by congress itself. The General Accountability Office (an investigative agency of congress) was tasked to look into the performance of the SS disability program. The conclusion was that there were some judges who were less productive, but that it is impossible to tell why, because the cases vary to the extreme in the number of issues which must be considered and decided by the judge. An extremely difficult case would naturally take much longer than a relatively routine case. The one GAO finding Mr. Astrud doesn't want the public to hear about is that the GAO found the chief reason for the backlog is agency mismanagement "for decades" and that the SSA is still using business practices which were discredited as ineffective "years ago." That may be the real reason Mr. Astrue wishes to place the blame on the administrative judges.

Robert Cornett's picture
Robert Cornett - Sep 5, 2008

I have been a Social Security Disability attorney for more than 20 years. I have handled well over 2000 cases. My experience has been that the vast majority of judges work very hard at moving cases along. The problem seems, at least from my perspective, to be a shortage of experienced support staff to allow the process to move faster at the ALJ level. Getting rid of the Reconsideration level would also speed up the process by several months. I personally think that level of a claim is a colossal waste of time, we either win at the initial claim level (rarely) or at the ALJ level, virtually never at Recon.

Jack Le's picture
Jack Le - Sep 5, 2008

As a disability insurance agent, I encourage anyone reading this to go out there and buy your own disability insurance policy from any well rated insurance company. Relying on the Social Security Administration to help you and your family in case of a disability is a big mistake. The SSA's definity of total disability is horrible. Their time of processing a disability benefit application is horrible. Their rate of denying a claim is horrible. Don't set your family up for the aganizing ordeal.

Go hope on the computer and start requesting quotes for disability insurance and start an application. Your most important asset is your ability to earn and income, no go insure it. The foundation of all of your financial aspirations is based on your ability to earn and income. Go insure it. Don't leave it up to the government.

Pages