| RALEIGH,
N.C. – 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 a first 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
plan to hire at least 150 new appeals judges to reduce
the backlog, which has soared to 755,000 from 311,000
in 2000, will require $100 million more than the president
requested this year. 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 judges, federal officials predict
even longer waits.
Progress cannot undo the three years that Belinda Virgil
of Fayetteville has worried since her application was turned
down. Tethered to an oxygen tank 24 hours a day because of
emphysema and life-threatening sleep apnea, Ms. Virgil lost
her apartment and has alternated between a sofa in her daughter's
crowded house and a friend's place as she waits for answer
to her appeal. "It's been hell," said Ms. Virgil, 44, who finally got her
hearing in November and is awaiting the outcome. "I've
got no money for Christmas, I move from house to house,
and I'm getting really depressed." The disability process
is complex, and the standard for approval has, from the
beginning in the 1950s, been intentionally strict to prevent
malingering. But it is also inevitably subjective in some
cases, like those involving mental illness or pain that
cannot be tested. In
a standard tougher than those of most private plans, recipients
must prove that because of physical or mental disabilities
they are unable to do "any kind of substantial work" for at
least 12 months – if an engineer could not do his job
but could work as a clerk, he would not qualify – or
prove that an illness is expected "to result in death." In
an interview, the commissioner of Social Security, Michael
J. Astrue, said that outright fraud was rare, but that
many cases on appeal were borderline. In addition, there
was tighter scrutiny following widely publicized charges
in the 1970s that money had been wasted on recipients whose
conditions improved. Of the approximately 2.5 million disability
applicants each year, about two-thirds are turned down
by state agencies, which make decisions with federal oversight
based on paper records but no 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, two-thirds eventually
win benefits. Mr. Astrue and other officials attribute
the high number of reversals to several causes: Those who
file appeals tend to be those with stronger cases and with
lawyers who help them gather persuasive medical data. During
the extended waiting period, a person's condition may worsen,
strengthening the case. The judges see applicants in person,
and have more discretion to grant benefits.
Requiring face-to-face
interviews at the initial stage could reduce the number of
appeals, Mr. Astrue said, "but given the
huge volume of cases coming through, it would be incredibly
costly and the Congress is not willing to fund that." The
growing delays in appeals over the last decade resulted
in part from litigation and financing shortages that prevented
the hiring of new administrative law judges. In addition,
the number of applicants is rising as baby boomers reach
their 50s and 60s. "Once the system got overloaded, it fell farther and farther
behind," said Rick Warsinsky, legislative director of the
National Council of Social Security Management Associations,
which represents managers from the agency. If approved,
those who have paid into Social Security receive income
comparable to retirement benefits, averaging more than
$1,000 a month. The poor, and severely disabled children,
receive Supplemental Security Income checks, $637 a month
in 2008. Charles T. Hall's law firm in Raleigh has the
state's largest disability practice, with six lawyers representing
about 2,500 clients. The lawyers usually work on contingency
and collect 25 percent of back payments, to a limit of
$5,300. Mr. Hall said that about one client a month died
while awaiting a hearing. Far more clients, he said, run
out of money and lose their homes. In the past, said Walter
Patterson, a disability lawyer in Charlotte, N.C., clients
who received a foreclosure warning were pushed up the waiting
list for quicker hearings. But as hearing offices became
overwhelmed, he said, they expedited cases only after seeing
an actual eviction notice. By that time, it was usually
too late to help. Thomas Airington, 48, who formerly ran
a car-emissions testing business, was told his appeal,
filed last spring, would be expedited when he showed officials
an eviction notice. In the meantime he lost the house,
which his parents had bequeathed to him. A hearing date
has still not been set. "If I'd been approved in time, I could have saved my house," said
Airington, who is staying with a brother near Raleigh.
Mr. Airington, who has pins in his spine from a car accident
in 1992, shattered a knee when he fell 30 feet in 2005,
has nerve damage in his feet and suffers from chronic arthritis
and depression. The rejection letter he is appealing said, "We
have determined that the condition is not severe enough
to preclude work." Mr. Airington said he tried a desk job
but found he could not sit for long, and tried working
as a stocker in a grocery store but could not reach for
shelves. Whatever the outcome, he, like many applicants,
is in limbo while he waits.
The extended
delays can also mean extra burdens for state welfare agencies.
In New York state, about half the 38,000 people awaiting disability
appeals, for an average of 21 months, are receiving cash assistance
from the state, said Michael Hayes, spokesman for the Office
of Temporary and Disability Assistance. Mr. Astrue, the latest
of several Social Security commissioners to promise speedier
decisions, said the agency had already taken steps to ensure
quicker initial approval for those most clearly eligible and
was holding more video hearings. But by all accounts, a major
increase in money, judges and support staff will be needed
to have a significant impact on the problem. Mr. Astrue
said that if the budget impasse continued, leaving the
agency budget at its current level, "not only will we not
do any hiring, we're looking at furloughs." A first step
of raising the number of judges to 1,200 will require at
least $100 million extra for the agency beyond the $9.6
billion that President Bush has proposed for the 2008 fiscal
year, Mr. Astrue said. The Democratic-controlled Congress
voted a $275 million increase for the agency, but Mr. Bush
vetoed the whole spending bill, calling it profligate. If
the stalemate continues, the government will probably operate
on the basis of continuing resolutions, which will keep
agency spending at last year's level and doom the plan
to add judges.
Richard and Vicki
Wild and their adult son Mark, of Hillsborough, N.C., were
mystified that Mark's case would even require a judge. Hospitalized
with increasing frequency since his severe diabetes was discovered
at age 19, when he was found unconscious in a bus station,
Mark Wild was eager to work as a chef. But over the course
of 15 years he tried and lost jobs as a waiter and a cook.
He had to drop out of culinary school because he was hospitalized
so often, his parents said. "We had 10 years' worth of hospital records and unanimous
opinions from the doctors," said his father, 62. But his
son's initial application was turned down in 2003. The
family had gone into debt because of medical bills, nearly
losing their house of 30 years, but found a lawyer to file
an appeal. The son, by then in his mid-30s, had to wait
two more years to get a hearing scheduled. As
his hearing date in October 2006 approached, Mark told
his parents he feared another rejection. "It was his last chance
at any dignity, and he said if they turned him down it would
be too much to take," Ms. Wild, a nurse, recalled. On Tuesday,
Oct. 17, 2006, just a few days before the hearing, she
woke up to find her son gone. On his desk lay his watch,
his ring and a bullet. On
the following Thursday, she got a call at work from their
lawyer. "I just wanted to give you the good news," she said
he told her. "Somehow, the judge has already approved the
disability, it's a done deal, Mark's got it." Two hours
later, a deputy sheriff and a chaplain arrived to say that
hunters had found Mark's body in the woods, dead of a self-inflicted
gunshot wound. "No one can say for sure, but we're convinced that his despondency
and fear about the disability decision contributed to his death," said
his mother, who wears a pinch of her son's ashes in a small
tube on a necklace. Richard Wild has tried to go back to work, but he says he
is so depressed that he cannot do his job. He is applying for
disability, but he knows that he cannot expect an answer anytime
soon. |
NEWS 
