Thursday, May 21, 2009

People who apply for disability benefits sometimes wait years for a ruling

By ALEX BRANCH - Fort Worth Star Telegram - May 21, 2009
HALTOM CITY — Linda King says diabetes and heart problems forced her to quit her office job and apply for disability benefits in January 2007.

While she waited, she made ends meet off the $300 to $350 her cousin gave her every month. That had to cover bills, medicine, and lunchmeat and soup.

"It’s really hard, but you tell yourself you can do it while you wait," said the 61-year-old Haltom City woman.


Two years and five months later, she still waits.

King, who was initially turned down for benefits, is among more than 750,000 Americans trapped in a backlog of disputed Social Security disability claims. Applicants who seek an appeal hearing sometimes wait years for one.

In Fort Worth, applicants as of April waited an average of 355 days from the time they request a hearing until they get one, according to the National Organization of Social Security Claimants’ Representatives. The wait in Dallas ranges from 342 to 418 days.

Social Security Administration officials have blamed the backlog on a rising number of claims and staffing shortages. Earlier this year, Commissioner Michael Astrue warned that the faltering economy had triggered a 10 percent increase in new claims, hampering the agency’s efforts to reduce the existing backlog.

"It’s so frustrating," King said. "I check my mailbox every day and hope I get an answer."


A long process

To request an appeal hearing, applicants’ claims must first be denied twice. The first decision takes an average of 106 days, according to administration officials.

The second ruling usually takes 45 to 60 days, said Marva Foster, team leader for Mash Inc., a Fort Worth agency that guides people through the application process.

About 64 percent of applicants are initially denied.

Hearings are held before administrative judges, and that’s where things can grind to a halt. The agency is handling twice the number of claims it did in the 1990s, according to administration figures.

"If you’ve been waiting a long time, of course you’re frustrated," said Tom Clark, spokesman for the North Texas Social Security Office. "We’re working very hard to reduce that backlog."


Progress has already been made, he said. The agency now has fewer than 300 cases nationwide that have lingered at least 900 days — down from about 135,000 cases.

It has also opened a National Hearing Center to concentrate on backlogged cases, hired 100 administrative judges and identified about 50 illnesses as cases to be expedited.

Also, the administration’s work force will grow by about 3,200 under President Barack Obama’s 2010 budget plan to handle retirement and disability claims from aging baby boomers.

'It’s really sad’

In the meantime, those ailing and caught in the backlog face struggles.

"They get no medical benefits, no income, unless there is a spouse working," Foster said. "If you got out and try to find some kind of job while you wait, you risk being denied because, well, now you’re working."


Fort Worth’s average wait time is better than most regions. It was the 18th shortest on a list of 142 U.S. processing centers. However, advocates for applicants say that 355 days is still a long time.
King has worked most of her life, never smoked or drank and has been hospitalized several times because of her heart condition, her lawyer Daniel Gregory said.

"Her car is broken down, so she couldn’t even get out to apply for food stamps," he said. "It’s really sad to see her having to live in such difficult circumstances."


King finally got her hearing in January. But she still hasn’t received a ruling from the judge.

"We just hope it comes soon," Gregory said.


The economy has stoked fears that the backlog will get worse. People with disabilities have a lower employment rate and have a harder time finding a new job if they get laid off, said Ethel Zelenske, director of government affairs for the National Organization of Social Security Claimants’ Representatives in Washington, D.C.

"A lot of people with disabilities try to work even if it is not the best thing for them," she said. "They would rather not apply and only do it when they feel like they have to."

Needed paperwork

Experts say one thing applicants can do to help shorten their wait time is to carefully document their condition.

The most common reason for initial denials is incomplete information, they say.

"You can’t just walk in and say, 'I’m really sick,’ "
said Stephanie Weatherford, who helps applicants through a Tarrant County Mental Health and Mental Retardation program.
"They will say, 'Show me the record.’ If you can show them the medical records, you will most likely get approved."
Others whose initial claims are denied often failed to follow up on the claim in a timely manner, she said. There are deadlines to appeal rulings.

"It is daunting and intimidating for people who don’t do a lot of paperwork," Weatherford said.


For her part, King says she had done her best preparing her appeal.

"All I can do now is hope and wait," she said. "One of these days I’ll get an answer."


By the numbers 750,000: Pending claims nationally

106 days: Average wait for an initial ruling on a claim

64 percent: Percentage of claims initially denied

355 days: Average wait for an appeal hearing in Fort Worth

3,200: Workers to be added to the Social Security Administration
Read more in the Fort Worth Star Telegram

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