DISABILITY CASES LAST LONGER AS BACKLOG RISES

The New York Times recently reported that steadily lengthening delays in the resolution of Social Security disability claims have left hundreds of thousands of people in a kind of purgatory, 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. 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. Without new hirings, federal officials predict even longer waits and more of the personal tragedies that can result from years of painful uncertainty.

Of the roughly 2.5 million disability applicants each year now, about two-thirds are turned down initially by state agencies, which make decisions with federal oversight based on paper records but no face-to-face interview. Most of those who are refused give up at that point or after a failed request for local reconsideration. But of the more than 575,000 who go on to file appeals — putting them in the vast line for a hearing before a special federal judge — two-thirds eventually win a reversal.

The Massachusetts Picture

Sarah F. Anderson managing attorney, Health & Disability Unit, Greater Boston Legal Services says that we are fortunate in Massachusetts to have a hearing office with some of the lowest “claims processing times” in the nation, but that still means it's about a year from date of filing an ALJ hearing request (hearing before an administrative law judge) to date of ALJ decision. Winning a case at the ALJ stage means that a client has already been denied twice. In reality it means that many people have lost something else such as housing or access to care while waiting for SSA to decide their claim.

Medical Staff Can make a difference

"Facilitating applications for disability benefits is perhaps the single most important intervention that clinicians can offer to minimize the health risks associated with poverty and to assure a better quality of life for many homeless people. Helping a previously uninsured patient obtain health insurance coverage also benefits the health care provider." So wrote Doctors Jim O'Connell, Paul Quick and Barry Zevin in the most recent version of Documenting Disability: Simple Strategies for Medical Providers, p.4, National Health Care for the Homeless Council (Sept.2007), www.nhchc.org/DocumentingDisability2007.pdf. Anderson says “As a legal services attorney, I agree with this statement. It can be applied to a broader range of individuals who are applying for disability benefits: children, adults with dual diagnoses, and just ‘plain vanilla’ poor people. Last year, our office won over 90% of the cases taken to a hearing before an administrative law judge (ALJ), and returned over two million dollars in past due benefits to our clients. While this is great, how much better it would have been if our clients' applications had been approved the first time they applied, and didn't have to wait 1.5 to 2 years or more to get the benefits for which they qualify. The stakes for clients are high, and having clinicians involved at the initial stages of the disability application process can pay dividends for both client and clinician.”

-Adapted from “Disability Cases Last Longer as Backlog Rises” By Erik Eckholm, The New York Times, December 10, 2007 retrieved at: http://www.nytimes.com/2007/12/10/us/10disability.html?pagewanted=2&ei=5070&en=3d552535aca08d24&ex=1197867600&emc=eta1 and e-mail correspondence with Sarah F. Anderson, Managing Attorney, Health & Disability Unit, Greater Boston Legal Services.

12/07