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Disability claimants wait ... and wait
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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.
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Having been a judge with Social Security's disability office for two years and a representative of claimants for 18 years before that, I have some insights into this issue.
First of all, the backlogs are not the fault of the judges, the Commissioner's own Inspector General (IG) found. Presumably, there are a few, very few, low producers; but the agency has never set a standard below which they would file disciplinary action for low production. They imply that if a judge does not produce 500 decisions a year, he or she is subject to action; but last year the average judge production was around 450, which was a significant increase, so that would mean going after most of us.
Secondly, the Commissioner is asking Congress for authority to directly discipline judges in certain circumstances, rather than using existing law to take offenders before the Merit Systems Protection Board (MSPB). He complains that under MSPB procedures, a bad judge gets a free ride while being prosecuted. But what about judges unfairly charged? Are they supposed to go without income while defending themselves?
Thirdly, the Commissioner's recent IG report pointed to many instances of mismanagement, rather than low producing judges, as reasons for the backlog. On the other hand, the Commissioner has done some good things, like establish National Hearing Centers (NHC), to balance eneven workloads throughout the country and lower the backlog. These NHC's offer electronic hearings to claimants wherever they live, heard by judges in central locations.
Finally, I would point out that the passage of time works as an advantage to most claimants at the judge level. These are folks who have already been denied once or twice, based on the medical records at that time. With the passage of time, an increase in their medical records, and perhaps a deterioration of their conditions, they can often qualify for disability, whereas they could not before. The national average of paid cases is around 2/3rds at the judge level. And another initiative of the Commissioner is what he calls "compassionate allowances," in which they statistically identify the types of cases that are almost always paid by judges, or which typically lead to early death, and they go ahead and pay those without waiting for a judge hearing.
There is more to this than meets the eye in the context of media soundbites. I obviously do not speak for the agency in this letter.
D.W. Haigler, Jr.
I became disabled under SSA rules at the age of 18 when the state released me from a mental hospital because I had reached majority. But during my last review they cut off my benifits even though my diagnosis is schizoaffective SSA said that my only impairment is depression and I'm no longer depressed so they cut me off. They also sent the state patrol CDIU to investigate me. This is a very cruel thing to do to someone with paranoia. I am now 40 and am expected to get a job in this depressed dog eat dog market. God knows I've tried to work. I've had dozens of jobs over the years and when they see me talking to myself they fire me every time.
I am appealing and am supposed to keep getting benifits while I apeal but a computer stopped my checks anyway. SSA says they will get my checks started again but I've been three months without a check. If I was not a compulsive saver I'd be homeless now. I don't know if I can see my psychiatrist this month because I don't know if I actually have medicare anymore. Getting cut off has sent me into a full blown relapse too. SSA said I am still impaired but able to do some work. What work I don't know.
I became disabled under SSA rules at the age of 18 when the state released me from a mental hospital because I had reached majority. But during my last review they cut off my benifits even though my diagnosis is schizoaffective SSA said that my only impairment is depression and I'm no longer depressed so they cut me off. They also sent the state patrol CDIU to investigate me. This is a very cruel thing to do to someone with paranoia. I am now 40 and am expected to get a job in this depressed dog eat dog market. God knows I've tried to work. I've had dozens of jobs over the years and when they see me talking to myself they fire me every time.
I am appealing and am supposed to keep getting benifits while I apeal but a computer stopped my checks anyway. SSA says they will get my checks started again but I've been three months without a check. If I was not a compulsive saver I'd be homeless now. I don't know if I can see my psychiatrist this month because I don't know if I actually have medicare anymore. Getting cut off has sent me into a full blown relapse too. SSA said I am still impaired but able to do some work. What work I don't know.
How bad can things get? If one looks at the current federal budget there is a provision in the budget to shave down the current case load for social Security by two thirds. One would assume that the only reason there is such a swell in social security rolls is because of a free lunch. The current administration has no concept of what an actual disability is. The current policy of cutting benefits for disabled adults is nothing more than an outdated ideology of Calvinism. Hopefully the next administration will have ideas that are in step with our current century.
I am an attorney in NJ. My firm handles hundreds of workers' compensation and social security disability cases each year and we have seen how the slow pace of the system can devastate families, both financially and emotionally. My experience is that Social Security cases take over two years from first application to hearing before an administrative law judge.
Our clients find it difficult to accept that during this time period, they will probably deplete their savings, borrow from relatives and lose self esteem - all while being too ill or injured to do anything else but wait for the system to work.
I don't think, however, that the system is broken. Consider this: many first time disability applicants are adjusting to news of a difficult diagnosis, perhaps MS or a chronic back problem. While they and their doctors no longer believe they are fit for the job they once did, perhaps there is other, more sedentary work, that they could do given the proper retraining. Federal programs, administered by states, offer vocational rehabilitation at little or no cost to the applicant. I have had some success stories with clients we have referred to these programs and frankly feel that the harder to prove cases should be required to at least meet with a vocational counselor during their wait for a hearing to see if there is some other field in which they can earn a living.
For those contemplating an application, know that qualifying for Social Security Disability is not a panacea. Those who do qualify often find themselves living in tough economic circumstances anyway, even poverty, especially if they are without other resources or a working spouse.
As an SSA Disability Representative, I have seen(and have personally experienced)our clients lose their homes, families fall apart, and even die; all because the process is so long, and denies so many people for unbelievable reasons (eg: they don't consider conditions like cancer/lupus/MS, and many others, serious enough unless the applicant is in such severe shape that they almost have to be dying. We've lost an applicant to cancer before his application was even reviewed.
Children with severe needs are denied because they can't pass the "Resource & Assets" test. They can't receive treatment without some kind of insurance. People are denied because there is not a solid and current history of treatment - because they have no insurance to pay for it!
It goes on and on. Sometimes I have to close my door to have enough privacy to scream and weep.
From initial application, denial, reconsideration (if eligible), and if denied again, until the day you see the judge, can take years. The problems are not just with the judges - the whole system is broken, and it's the very people who need benefits who pay the price.
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