Disabled workers often wait years for Social Security benefits; recession worsens situation

Spike in disability claims clogs overloaded system

WASHINGTON — Nearly 2 million people are waiting to find out if they qualify for Social Security disability benefits. It will be a long wait for most, even if they eventually win their cases.

The Social Security system is so overwhelmed by applications for disability benefits that many people are waiting more than two years for their first payment. In Ohio, Michigan, Minnesota and other states, the wait can be even longer.

The Social Security commissioner, Michael J. Astrue, says the delays are unacceptable, particularly for people who have paid payroll taxes for years to support the system and now are unable to work because of debilitating medical problems. Astrue has had some success in reducing a case backlog that has plagued the system for years. But a spike in new applications, linked to the economic recession, threatens to swamp the system again.

Claims typically increase in a bad economy because many people who worked despite their disabilities get laid off and apply for benefits.

About 3.3 million people are expected to apply for benefits this year. That’s 300,000 more than last year and 700,000 more than in 2008.

Nearly two-thirds of those claims will be denied by state agencies overseen by the Social Security Administration. Most of these people will drop their claims. But for those willing go through an appeals process that can take two years or more, chances are good they eventually will get benefits.

People who win claims can get retroactive benefits.

“The most important thing we can do to improve the disability process is to make the right decision as soon as possible,” Astrue said at a recent congressional hearing. “Certainly, I’m not happy with the accuracy of the system, even though it is getting better.”

His goal is to clear the backlog of appeals hearings by 2013. “It takes longer to fix something than it does to break it,” he said.

Michael Quinn of Flint, Mich., said he waited nearly three years to get benefits after his initial application. Quinn was a sales representative when he was in a car accident in 2000 that left him with a shattered left leg, damaged vertebrae in his neck and 80 stitches in his head. Unable to do his job, he took a buyout from his employer and started working part-time jobs.

The work, he said, proved too difficult because he couldn’t bend over, lift anything heavy or even move his head enough to look up.

“I wanted to work because I’ve worked all my life,” Quinn said. “It was heartbreaking because I couldn’t work. There was so little I could do.”

Quinn, 64, said he filed for Social Security disability benefits in 2005 and his claim was denied. Quinn appealed to an administrative law judge and was awarded $1,900 a month — in 2008. He also got retroactive payments, dating to his original application.

“It’s the most helpless feeling in the world because you’re waiting for someone else,” Quinn said.

Qualifying for disability benefits is not easy. A doctor must determine that a disability is severe enough to interfere with an applicant’s ability to work. If applicants can’t perform their old jobs, officials see if they can adapt to new ones. The system is designed to weed out malingerers.

“Social Security has a very stringent, very tight definition of what constitutes a disability,” said Dan Allsup, communications director for Allsup Inc., an Illinois-based company that represents disability applicants, including Quinn. “It has to be that way to prevent the fraudulent, frivolous claims from getting into the system.”

About 12.8 million disabled people receive disability benefits. Some 7.1 million get Social Security disability, 4.2 million get Supplemental Security Income and 1.5 million get both. Disabled workers get an average of $1,065 a month from Social Security and $498 a month from SSI.

Disability benefits are financed by payroll taxes, the same taxes workers pay to support the retirement system.

Here’s how the application process works:

Applicants file disability claims with the Social Security Administration, which turns them over to state agencies, usually called Disability Determination Services. A doctor must verify that debilitating medical conditions will last at least a year. About 63 percent of initial claims are denied, after an average wait of 111 days.

Applicants in most states can appeal the decision to the same state agency. About 86 percent of those appeals are denied, after an average wait of an additional 104 days.

Applicants can then appeal to an administrative law judge. About 554,000 cases were decided at this level in 2009. The judges approved benefits in 63 percent of the cases, after an average processing time of 491 days.

Including the time it takes to file the appeals at each stage, the entire process takes an average of 777 days, or a little more than two years, according to the Congressional Research Service.

Applicants who are still denied benefits can appeal to a special council and eventually file a claim in federal court, but relatively few claims are awarded at these stages.

Astrue, who became Social Security commissioner in 2007, has worked to reduce the backlog of appeals before administrative law judges by hiring hundreds of judges and support staff. The number of cases pending before those judges dropped by 37,000, to just under 723,000, during the budget year that ended in September. It was the first drop in a decade.

The average processing time for that stage of the appeals process also dropped, from 514 days in 2008 to 491 days in 2009 and 442 days this year.

Many states have much longer waits.

Alaska, which recently opened a hearing office, takes an average 642 days for an administrative law judge to process a claim. Ohio takes 581 days, Michigan takes 564 days and Minnesota takes 560 days, according to Social Security statistics compiled by Allsup.

Despite improvements, the spike in new applications threatens to overwhelm the system.

“It’s straining to meet the present caseloads, and I don’t believe we have a well developed plan for what will happen in the future,” said Rep. Earl Pomeroy, D-N.D., chairman of the House subcommittee that oversees Social Security.

On the Net:

Social Security disability program: tinyurl.com/23mb78r

Allsup Inc.’s disability backlogs site: tinyurl.com/2v8dne5