Mistakenly
many Americans think that Social Security only offers retirement
benefits for senior citizens age 62 or older. Nothing could be
further from the truth. Social Security also provides disability
insurance (SSDI), Supplemental Security Income (SSI), survivor
benefits and helps with the Medicare program. I must admit that
I myself, was unaware of all that the Social Security program provides
for the American people. Social Security Disability (SSDI), is
an insurance plan administered by the Federal Government that is paid
for by FICA Tax deductions out of American's hard earned
paychecks. Most Americans know nothing about this insurance
unless they need to apply for this benefit themselves. It was
created to be a safety net for millions of disabled Americans, and for
many it has become their only lifeline for survival. There is a
huge shameful scandal involving this program, that most Americans know
nothing about unless they need to apply for this benefit themselves,
and the misconduct and neglect, that our government has perpetrated
against the weakest citizens of this nation is an atrocity! Due
to current program problems applying for this benefit often
exacerbates/creates new health issues, and many lose all their
financial resources, their homes, even their lives while waiting for
help. If you don’t suffer from depression before applying for
benefits, chances are you will, in fact many contemplate or attempt
suicide. It seems that this program is currently structured to
be very complicated, confusing, and with as many obstacles as
possible, to discourage claimants, sucking the life out of them,
hoping they “give up or die” trying to get their benefits. That
is how the government keeps your money from you, in order to use it
for “pork barrel” spending, catering to special interest groups,
investment in other countries, making bombs or starting wars. In
our country you’re required to have auto insurance in order to drive a
car, you pay for health insurance, life insurance etc. If you
filed a claim against any of these policies, after making your
payments, and the company tried to deny you coverage when you had a
legitimate claim, you would be doing whatever it took, even suing, to
make them honor your policy. Yet the government is denying
Americans their right to legitimate SSDI benefits everyday, and you
should be outraged!
Until 1996 I was perfectly healthy and never expected to have to use
these funds until I was old enough to retire. Unfortunately in
November of 1996 I hit my head on the doorframe of my car as I was
exiting the vehicle, and within a week a huge lump called a hematoma
(blood clot) formed on the back of my head between my scalp and
skull. I endured months of excruciating pain and eventually
lapsed into a coma. The result is an incredible story of medical
incompetence, which resulted in major brain surgery on 1/14/97.
Since my brain surgery in 1997, I take an aspirin a day and pray as my
only treatment for this huge clot in my brain. I also now suffer
from several incurable autoimmune disorders including: Scleroderma,
Raynaud’s Disease, Rheumatoid Arthritis, Fibromyalgia, Calcinosis,
Sjogren’s, Telangiectasias, Hashimoto’s Thyroiditis, which it is
believed were caused from my autoimmune system working so hard to
fight the brain infections, that it never turned off, and is now is
attacking all the other parts of my body.
“Autoimmune
diseases are among the top ten killers in the developed world.”
Cause
Of MS And Diabetes - Pretoria News - 3/12/01
I
was hospitalized again in the Spring of 2001, from what I thought was
a heart attack, but was ruled to be a result of my autoimmune system
attacking my esophagus, causing severe pain and esophageal reflux
disease. Scleroderma is a collagen disease, which in its extreme form
hardens tissues and vital organs throughout the body and eventually
kills you. The worsening Rheumatoid Arthritis causes fatigue and lots
of pain in the joints throughout the whole body, and Fibromyalgia
causes major fatigue and pain in the muscle tissues and nervous
system. The Calcinosis has caused very painful stone like
calcium deposits to form on my joints and fingers. As my
Raynaud’s disease worsens each year I face the real possibility of
hand/arm – foot/leg amputations, and damage to my internal organs as
well, and I suffer from very painful ulcerations all over my fingers,
which I endure for weeks at a time until they heal, only to recur
again later. The only medicine I can take to try and reduce the
symptoms does not help much at all. In July 2004 I had surgery
to remove stage one melanoma skin cancer and I am hoping that it was
caught in time. I have severe neck, spine and back pain,
numbness, tingling and pain in my arms, hands and feet, Osteopenia of
the hips, Osteophytes in my right knee, and Plantar Fasciitis in my
left foot which makes it painful to stand or walk. I have severe
headaches and nosebleeds, irritable bowels, memory loss, inability to
sleep or concentrate, anxiety and situational depression as the result
of all my health problems and worsening financial situation. I
am very anemic to the point where I needed IV iron infusions, but they
made my irritable bowel symptoms worse, so now there is nothing I can
take to stop the anemia. I was just diagnosed in 2007, with
having an En Plaque Meningioma (brain tumor along the tip of right
temporal lobe) growing on the surface of my brain, behind my right
eye. Due to my medical history, shape and location of the tumor,
any further treatment is not feasible at this time, so my brain
surgeon is going to monitor it with regular MRI’s for now. I also
discovered that I have Celiac disease – allergies to Gluten/Gliadin,
wheat, rye, oats, barley, malt, maltodextrin, whey, wheat starch,
modified food starch, bran, orally ingested grain alcohol, and
Diverticulosis so I must also avoid all nuts, kernels, seeds
etc. I must read all labels on any food that I purchase/eat and
any medicines that I take. and anything that I can eat/take now is
often very expensive. It has made an already severely
compromised lifestyle even more unbearable. Since my body is
under so much stress I have frequent very painful Shingles
attacks. In addition I have way too many more health issues to
list here, which fill 2 pages of 8x10” paper single spaced. Since
there is no cure for these diseases, I just live each day as if it
will be my last, making the most of every second that I have. My
medical horror story can be found on my website:
"A Bump On
the Head"
I
did my best to function in spite of my fate but the diseases
progressed to a point where I am permanently disabled, can no earn an
income, and every day life causes me intense pain beyond description
among other things. In December of 2001, I applied for Social
Security Disability which I assumed would be there to help me in my
time of need. For 30 years of my life I contributed to the
Social Security system like millions of people do every day, but I was
very unaware of the problems with this program, until my first
experience with the SSA. It’s common knowledge on the streets
and in legal circles that it is RARE if anyone gets accepted the first
time they apply, and as mentioned before, the system is set up to
discourage claimants, even those who feel brave enough to tackle the
system. In spite of all the discouraging stories I heard from
others, I figured every case was different, and anyone with the
laundry list of illnesses that I had, and the documentation to prove
it, that surely I would be able to get the help that I
needed. I was sorely mistaken and my experience with the Social
Security Administration, trying to get my SSDI benefits was not a
pleasant one by any means. The following is what I have
discovered in the process.
States
Of Denial
If you should suddenly become disabled and have to file for Social
Security Disability benefits, you may want to consider moving before
filing your application. Since Social Security is widely known
as a Federal program, where you live should not affect your ability to
obtain benefits. Sadly this is not the case. What most don’t
realize is that after you file your initial disability claim at your
local Social Security Office or online, that information goes to
DDS/Disability Determination Services facility in the state where you
live to be processed. There, the most crucial part of your
disability claim, the medical portion, is reviewed by a
caseworker/adjudicator and medical doctor on their staff who never
sees you, and in most cases never even communicates with you at
all. Then they decide whether or not they feel you are disabled
based on the information that you and your doctors have
provided. What would be an incentive for states to deny Federal
claims? Since many Social Security Disability claims are SSI or
both SSI/SSDI combined claims and many states offer to supplement SSI
payments at a higher benefit amount, therefore they want to keep as
many off the rolls as possible so they do not have to pay out this
supplement. Thus the explanation for the fluctuation in
denial/approval/backlog rates by state. Unfortunately there’s
very little if any oversight, on these state offices to ensure they
are making the proper decisions on disability claims. I
personally have caught them in fraud, negligence, and major security
breaches in the processing not only of my case but other cases as
well. That’s why so many claimants appeal to the hearing level,
where a huge percentage of bad state decisions are overturned and
cases are finally approved. If better decisions were made at the
initial stage there’d be no need for hearings in the first place, yet
it seems this fact has been greatly ignored. For the future, the
most ideal customer service scenario would be to have ALL phases of
the disability claims process be handled directly out of the SSA field
offices. Since SSDI/SSI are Federal benefits why has a State DDS
level been added to this process at all? One must question why
this common sense solution has not been instituted. SSA,
Congress and the GAO must look into reforming this program in such a
way that ALL who handle benefit claims are Federal employees and
consolidate ALL phases of the SSDI/SSI process into the individual SSA
field offices throughout the nation.
The
Stigma That SSDI Claimants Encounter
SSDI claimants were once hard working, tax paying citizens with hopes
and “American dreams” but due to an unfortunate accident or illness,
have become disabled to a point where they can no longer work.
SSDI is not welfare, a hand out, reward, golden parachute or jackpot
by any means, and most people would be hard pressed to survive on
it. Yet, often claimants are treated like criminals – viewed as
frauds trying to scam the system, and that the SSA must “weed out”
them out by making it as hard as possible to get benefits. Yes,
I’m well aware as I write this, that there’s some who’ve abused the
system and that’s a shame, because it casts a bad light on those who
really need this help. The percentage of claims that in fact,
aren’t legitimate is very miniscule and there are methods in place to
“filter them out”, without causing harm to legitimate claimants.
In 2007, the average monthly Social Security Disability Insurance
(SSDI) benefit was only $979 (Social Security Administration, Fact
Sheet 2007). Nobody in their right mind would want to go through
this process, and end up living in poverty on top of their illnesses,
if they could in fact work. They would much rather have their
health back and the jobs they once had before their lives were changed
by their illnesses or accidents.
After filling out several pages of paperwork which I was told was
greatly reduced from which it had originally been, and submitting a
huge stack of medical records supporting my claim, I was told it would
take 4-6 months to go through the process. I was shocked and
asked what I was supposed to live on, and I was told to apply for
Social Services (Medicaid, food stamps and cash assistance) while my
claim was being reviewed. I did just that, and was denied any
sort of help based on the cash value of a life insurance policy that
is not even enough to bury me when I die. Due to all my
illnesses if I cashed in that policy I would never be able to get
insurance again! That process and paperwork was very difficult
and humiliating and then to be denied that help too, just added even
more to my stress and misery.
Social
Security Disability Program Problems - Contributing Burden Factor on
Medicaid/Social Service Programs For States
Many SSDI claimants are forced into poverty while waiting for their
claims to be processed (many years in some cases), and then must file
for state funded help such as cash assistance, food stamps, Medicaid
and other Social Service programs, in order to survive. Now they
must endure another horrendous, very stressful and demeaning process,
to say the least, after they have already lost everything due to the
problems with the Social Security Disability program, including the
huge claims processing backlog. For example in New York State,
about half the 38,000 people now waiting on disability appeals, for an
average of 21 months, are receiving cash assistance from the state
(New York Times 12/10/07). This problem could be greatly reduced
once this Federal program is fixed, and the states would then reap the
benefits in the long run. State politicians need to put pressure
on Congress to put more funds into the SS system to hire more
qualified claim examiners, and to better educate their employees,
doctors, also the claimants themselves, to speed up the process.
Claimants who file for Social Service programs while waiting to get
SSDI benefits, in many states have to pay back the state out of their
meager SSDI benefits once approved, which in most cases keeps them
below the poverty level and forces them to continue to use state
funded services. They are almost never able to better
themselves, and now for the rest of their lives will have to rely on
two funded programs instead of just one. If a healthy person
files for Social Service programs and then gets a job, they do not
have to reimburse the state once they find a job, for the funds they
were given while looking for work - why are disabled people being
discriminated against? In all states there should be immediate
approval for Social Services aid (food stamps, cash assistance,
medical assistance, etc) for SSDI claimants that does not have to be
paid back out of their SSDI benefits once approved. The practice
of pay back to the states for aid while waiting for SSDI benefits is
blatant discrimination against the disabled, and needs to be
eliminated immediately.
I was hoping beyond hope that I would soon get the news that my SSDI
claim was approved, but instead on 4/25/02, I got the incredible news
that my claim had been denied! I’d heard too many horror stories in
doctor’s waiting rooms and other places I’d been, of people who had
lost everything, were in homeless shelters, totally bankrupt, had no
health insurance and still had to deal with the stress of all their
illnesses. I knew first hand what they meant now, since at this
point, I was almost there myself. I didn’t understand how it was
possible that anyone could read about all the medical problems I have,
and it not be totally transparent that I should qualify for benefits,
and that I never should’ve been denied in the first place! I
immediately filed for an appeal, had to go through an even more
complicated process and was told it would be at least August of 2003
before I got my hearing if I didn’t die first!
A dire needs case in the eyes of the Social Security System means that
you have to prove in writing, that you are going to have your home
foreclosed on, be evicted from your apartment or have your utilities
shut off. Nobody should ever have to deal with that sort of
thing when they are sick.! Most are not able to afford health
insurance, medicine, food, other necessities of life, and have to wipe
out their financial resources because of their inability to work, but
yet that is not even considered a dire need! Something is
seriously wrong with that picture. Remember, there is no cure
for any of the illnesses I have, and all the diseases are getting
worse by their clinical nature with each day that goes by, due to the
ever increasing stressful conditions I have had to live under – and
yet that was not considered a dire need in my case. The clot in
my brain and my worsening financial situation continue to keep me from
taking the medicines and seeing doctors that could help me deal with
this horrible existence. As far as I could tell at the time,
worsening health problems doesn’t seem to be a factor in speeding up
SSDI claims, since as mentioned earlier, there are several reported
cases of people who have died while waiting to get their benefits.
When I called the Office of Hearings and Appeals in Buffalo NY to
check on my claim on 9/13/02, the receptionist told me, that my file
was still in the un-worked status, which meant that nobody was
assigned to my claim yet, or even looked at the file at all since
March, when I originally filed my appeal. I expressed my disgust
that after six months in their possession that it had not even been
touched yet! I called them again on 1/23/03 and they told me
that STILL nobody had been assigned to my case and it would be a
MINIMUM of five months more or even longer since they were just
starting to work on cases that were filed in November of 2001!
This is outrageous when something this serious, and a matter of life
and death, could be handled in such a poor manner. No other
company or other government organization that I know of operates with
such horrible turn around times. If any other corporation in
this country did business like this, the majority of employees would
be fired on the spot, and the company would be shut down within a
year, yet these problems have been growing worse for decades.
The receptionist expressed her sympathy for my cause and literally
begged me to let others know (especially the government and press)
about how much of a problem they are having. Imagine my surprise
when I was calling them for help and they were begging me – a disabled
person, to get them help! I was told that there are only 50
employees handling hundreds of thousands of cases and they, along with
all of us claimants critically need help now! After my conversation
with the Buffalo office I did just that.
Overwhelming
Bi-Partisan Apathy
I contacted several national media outlets (TV, radio, print) who
showed no interest in the problem, even though this issue affects
millions of people all across the country. I wrote to ALL my
state, Congressional elected officials, including the attorney
general, the Governor, the President, Vice President, and various
other members of Congress. As a registered voter, I was very
disappointed, disillusioned, and disgusted that those whom I have
supported at the polls every year, when I asked for help in my own
particular case, the very few who responded at all, said that I needed
to be become homeless or have my utilities shut off before they could
help me, and there was nothing else they could do to expedite my
claim. This is appalling and totally unacceptable to me, that
never once, did they say that they would do anything to try and
correct the flaws in the system that cause the horrors we face.
This is bi-partisan apathy at its finest! Congressional offices
as part of their functions, contact Social Security on behalf their
constituents going through the SSDI process all the time, so our
elected officials are fully aware of all the problems, and they are
the ones who can help correct them. Yet, the government which
continually tells the rest of the world how to live, obviously does
not care, that millions of us are suffering and dying here at
home. I find it incredulous that they have done virtually
nothing to initiate reform of the system that is wreaking havoc on the
disabled citizens of this nation. While the majority of
Americans were shocked at the reaction of the Federal government in
the aftermath of hurricane Katrina, I wasn’t surprised at all to see
people dying in the streets. I shudder to think of how many more
lives will be further ruined or lost, when the mentally and physically
disabled victims of Katrina, other natural disasters, 9/11 victims who
survived that day, but are now disabled and facing a similar fate,
Veterans and the millions of other disabled Americans, encounter their
next experience with the Federal government as they apply for their
SSDI/SSI benefits. Little or nothing is heard about the service
men and women who are injured and have to go through this nightmare to
get their SSDI benefits, in addition to their struggles with the
VA. Horrible treatment for those who give of their lives to
protect our country. We are all being abused at the hands of our
government, and to date our cries for help have continually been
ignored. This apathetic attitude of our elected officials is not
only unacceptable, but it is criminally negligent, behavior, and they
need to be held responsible for it. We elected them, trusting
that they would protect, serve us and be there in our time of need,
but sad to say they have failed miserably at their jobs, doing us a
grave injustice in this area. It’s time that they speak out
about the crimes being committed against their constituents, and
create the legislation needed to correct decades of abuse and
corruption of this Federal program. Keep in mind a country is
only as strong as the citizens that live there, yet the current Social
Security Disability program preys on the weak, and decimates the
disabled population even further. This important issue needs to
be addressed now, and only our elected officials with your urging can
get the funding and create the legislation needed to fix this critical
problem. A personal goal of mine is to one day speak before
Congress, to raise the awareness of this crisis. Time is of the
utmost importance in this matter, as millions of SS Disability
applicants, even as I write this are suffering and losing everything,
including their lives, while trying to get their benefits.
I called the hearings and appeals office again in March 2003 and they
said it would be at least August 2003 before someone would look at my
case. I then did some research and found out that I could
request copies of the reports of the SSD IME doctor I was sent to, and
the notes of the original DDS claim examiner that denied me, and when
I received them, my worst allegations were then confirmed. Even
though I have no real neurological problems they sent me to a
neurologist to examine me, so of course he would find nothing wrong
with me and say that I did not qualify as disabled. I should
have instead, been sent to a Rheumatologist since most of my problems
are caused by the autoimmune disorders. Even though I filed my
disability claim based on all the physical problems I have, as a
PRIMARY diagnosis for disability, the DDS examiner purposely wrote
depression as a primary diagnosis instead of a secondary one, so of
course I would be denied based on that as well. This was after I
had already submitted tons of documents to prove my PHYSICAL
disability – reports/documents that he chose to ignore.
I then contacted the Social Security Office of Public Inquiries, which
told me to contact my elected officials, and I also filed a formal
willful misconduct complaint to the SSA Office of the Inspector
General in MD against the NYS DDS office. In April 2003, I requested
an immediate pre-hearing review of my case on the grounds of
misconduct and additional physical evidence. In order to get
that process going I had to fax the OHA copies of their own
regulations since the person I spoke with there had no clue what I was
talking about. Once they got all my paperwork to request the
review, a senior attorney, and then a hearing and appeals judge
granted my request, and my case was then sent back to the DDS office
that originally denied my claim. Finally it was seen by a
different person there who actually knew how to do their job. In
two weeks my case was approved at the DDS level, but then it was
selected randomly by computer (7 out of every 10 cases get chosen) for
Federal review and it took another three weeks to be processed
there. One month before becoming totally bankrupt, homeless,
losing my health insurance, and everything else I had worked for the
last 30 years of my life, all the retro pay just showed up in my bank
account exactly 1-1/2 years to the day from when I originally filed my
claim. The time I had to wait is totally unacceptable by any
reasonable standards. I actually received my official approval
letter on May 26th and finally won my case by myself with no lawyer
representing me.
You
Can Fight And Win Your SSDI Claim On Your Own – It Is Not Mandatory To
Have A Lawyer...
A bit of advice here – Take as active a roll as you can from day one
when you apply for benefits, and if you are too ill, try to get a
trusted family member or friend to advocate for you. Here is
where the “Squeaky wheel gets the grease” totally applies! Why
should you need to pay a lawyer to get benefits that you have
earned? This process should be set up so there is very little
need for cases to advance to the hearing and appeal stage since that
is where the major backlog and wait time exists. In order to
avoid a hearing, gather as much medical evidence as you can before you
apply to prove your claim so your chances of approval at the initial
stage are better. Also another bit of very important info, is
that you need to list EVERYTHING that is wrong with you both mental
and physical, and how these conditions prevent you from performing any
sort of work or daily activities. The current SSDI claims
process is set up to line the pockets of the legal system, as you are
encouraged from the minute you apply for benefits to get a
lawyer. The need of lawyers/reps to navigate the system and file
claims, and the cap on a lawyer's retro commission is also a
disincentive to expeditious claim processing, since purposely delaying
the claims process will cause the cap to max out - more money to the
lawyer/rep for dragging their feet adding another cost burden to
claimants. In other words the system is structured so that it is
in a lawyer’s best interest for your case to drag on since they get
paid 25% of a claimant’s retro pay up to $5300 – the longer it takes
the more they get. From the horror stories I hear from other
claimants, many attorneys are definitely taking advantage of that
situation. This is highway robbery without the ski mask and gun
and this travesty needs to change immediately! Instead, SS
should provide claimants with a listing in every state, of FREE Social
Security Disability advocates/reps when a claim is originally filed in
case their services may be needed. So if you decide that you
cannot do this on your own, there is free help out there if you look
for it, or keep after your attorney every step of the way, as there
are things that can be done to speed up this process, and do not let
them tell you otherwise.
Be
Aware Of Some Very Detrimental Regulations
NOTE: There are some very detrimental regulations that are very
important to know about, that will come as a shock to you if you ever
need to file for SSDI benefits. Again I must ask you here, “How
long could YOU survive with absolutely NO INCOME, if you got sick or
hurt, and could no longer work?” Under Federal law, there’s a
five month benefit waiting period, and five months of back money
withheld, which claimants will never see again. It was
originally six months but Congress voted to reduce it to five.
Apparently they feel that you do not need that money. Studies
have shown that most Americans have about two weeks of financial
resources to live on. SSDI recipients must also wait another 24
months, in addition to the 5 month waiting period from disability date
of eligibility (the date that SS determines that you were officially
disabled) in order to qualify for Medicare benefits. Keep in
mind that if you let any sort of health insurance policies lapse for
too long, and don’t maintain continuous health coverage, you may have
a very difficult time getting a new insurance carrier, since they may
hold your poor health against you, and consider many things as
“pre-existing conditions” so you may not be covered for those
illnesses. Congress expects a population who can no longer work,
to go without five months of retro pay, have no health insurance, and
wait several months to several years to have their disability claims
processed!
Conditions
Worsen For Those Seeking Social Security Disability Benefits
Millions of people across the country become disabled unexpectedly
(over 6 million people since the year 2000 applied for long-term
disability benefits). More than 1.3 million workers who applied
for SSDI benefits in 2005 were denied coverage. Nationally as of
September 2007, over 65% of disability cases were denied at the
initial stage of the disability claims process and it took from 101.8
– 113.7 days for claimants to receive the initial decision on their
claim. In all but 10 test states where the reconsideration phase
has been removed, 87.3% of cases were denied and the waiting time for
this phase was an average of 90.1 days. NY is one of ten test
states where the reconsideration phase of the SS Disability claims
process has been eliminated, causing even longer wait times, up to
several years in some cases, for claims to be processed. There
are about 1,417,103 total pending cases and out of that number,
154,841 are veterans. There even are cases of Veterans, rated
100% disabled by the VA, who get denied their SSDI benefits and end up
living in poverty on the streets. Horrible treatment for those
who protect and serve our country. In 2006 there were 2,134,088
new applications for SSDI benefits and as of October 2007, there have
been 1,844,898 new claims. If a claimant appeals the initial
decision, the national average time to process a hearings case is now
512 days, and that processing time continues to increase.
Nearly 300,000 hearings have already been pending over a year, and
there are only 1,096 Administrative law judges (ALJ’s), to hear all
those cases, with an average of 708.19 cases pending per judge
nationwide. Two-thirds of those who appeal an initial rejection
eventually win their cases (New York Times 12/10/07). Something
is extremely wrong when you have to deal with the pain and suffering
physically and mentally that comes along with the illnesses you have,
and then have to struggle so hard to get the benefits that you have
worked for all your life. It is outright abuse at the hands of
the Federal government. There is no data on the number of people
who originally filed a Social Security Disability claim that have
given up, and according to a CBS News Investigation “Disabled And
Waiting” which aired on 1/14/07, during 2006 and 2007, at least 16,000
people fighting for disability benefits died while awaiting a
decision.
The
Nightmare Will Continue
Proper funding is crucial to the success of SSA programs and there are
severe, very real consequences to claimants when SSA has reduced
resources. As if things are not already bad enough now, they are
about to get even worse, as the SSA is facing budget problems and
employee layoffs, and office closings, just as the growing numbers of
disabled/aging population needs their services more than ever. SSA has
already experienced staffing cuts and the SSA will now have only a 1
of 8 employee replacement ratio for those leaving SSA and who work
directly on the front lines in the field offices. This is a
claimant’s primary interview contact in the disability claims and
appeals process, and this staffing cut is a great cause of
concern. Even now there is not enough staff to handle the
current workloads, and the influx of new disability claims is only
going to increase over time, so we face very turbulent times
ahead. In a March 2007 survey of NCSSMA (Field Office and
Teleservice Center management) members in which over 2,000 responded,
over 80.0% stated that their office waiting times for the public had
increased in the past two years. About a third said that waiting
times were significantly longer. In addition, about 80.0% of the
respondents stated they did not have enough staff to keep their
workloads current. A January 2007 Harris poll designed to
evaluate the services provided by 13 federal agencies, the public
rated SSA at the bottom of the list and it was the only agency that
received an overall negative evaluation. At one time in the
recent past SSA was viewed by the public as one of the best federal
agencies in delivering service. Now after substantial staffing
cuts, SSA is at the bottom of the public acceptance list. SSA
Field Offices have lost over 2,500 positions since September 2005 and
nearly 1,400 positions since September 2006. In 2007 SSA Field
Offices are averaging about 850,000 visitors a week.
Constituents visiting these local Field Offices continue to experience
lengthy waiting times and the inability to obtain assistance via the
telephone.
When there are poor staffing levels, overworked employees, and lack of
training the public suffers. Here is just a small sampling of
some of the major problems with the current Social Security Disability
program and State Disability (DDS) offices who process the initial
phase/medical portion of disability claims:
Severe understaffing of SSA workers at all levels of the program
Claimants waiting for weeks or months to get appointments, and hours
to be seen by caseworkers at Social Security field offices
Extraordinary wait times between the different phases of the
disability claims process
Very little or no communication between caseworkers and claimants
throughout the disability claims process before decisions are made.
Employees being rude/insensitive, not returning calls, not willing to
provide information to claimants or not having the knowledge to do so
Complaints of lost files and in some states, case files being
purposely thrown in the trash rather than processed properly
Security Breaches - Complaints of having other claimants information
improperly filed/mixed in where it doesn’t belong
Fraud on the part of DDS/OHA offices, ALJ’s, IME’s – purposely
manipulating or ignoring information provided to deny claims, or
doctors stating that they gave medical exams to claimants that they
never did.
Claimants being sent to doctors that are not trained properly, or have
the proper credentials in the medical field for the illnesses which
claimants are being sent to them for.
Complaints of lack of attention/ignoring - medical records provided
and claimants concerns by Field Officers, IME doctors and ALJ’s.
Employees greatly lacking in knowledge of and in some cases purposely
violating Social Security and Federal Regulations (including
Freedom of Information Act and SSD Pre-Hearing review
process).
Claimants cannot get through on the phone to the local SS office or
800 number (trying for hours even days)
Claimants getting conflicting/erroneous information depending on whom
they happen to talk to at Social Security – causing confusion for
claimants and in some cases major problems including improper payments
Proper weight not being given to claimants treating physicians
according to SSA Federal Regulations when making medical disability
determinations on claims.
Complaints of ALJ’s “bribing” claimants to give up part of their retro
pay (agreeing to manipulation of disability eligibility dates) or they
will not approve their claims
Poor/little coordination of information between the different
departments and phases of the disability process
Complaints of backlogs at payment processing centers once claim is
approved
Federal Quality Review process adding even more wait time to claims
processing, increasing backlogs, no ability to follow up on claim in
this phase
NOTE:
These complaints refer to all phases of the SSDI claims process
including local field offices, state Disability Determinations
offices, CE/IME physicians, Office of Hearings and Appeals, the
Social Security main office in MD (800 number).
Ticket
To Work Program - Catch 22 – Fear and Mistrust of the SSA
According to SSA disability guidelines: Social Security pays
only for total disability. No benefits are payable for partial
disability or for short-term disability. You have a valid claim
if you have been disabled or are expected to be disabled for 12
consecutive months, or your condition will result in your death.
Your condition must interfere with basic work-related activities for
your claim to be considered. If your condition is severe but not
at the same or equal level of severity as a medical condition on the
list, then they must determine if it interferes with your ability to
do the work you did previously. If it does not, your claim will be
denied. If you cannot do the work you did in the past, the SSA looks
to see if you are able to adjust to other work. They consider your
medical conditions and your age, education, past work experience and
any transferable skills you may have. If you cannot adjust to other
work, your claim will be approved. If you can adjust to other work,
your claim will be denied. Currently the SSA forces the disabled
to go through years of abuse trying to prove that they can no longer
work ANY job in the national economy due to the severity of their
illnesses in order to be approved for benefits. The resulting
devastation on their lives, often totally eliminates the possibility
of them ever getting well enough to ever return to the work force,
even on a part time basis, in order to utilize the SS Ticket to Work
program. Yet ironically once they are approved they are allowed
to earn up to $900 and still receive benefits. Confusing to say
the least. Then sometimes weeks after they are finally approved
for SSD/SSI benefits, after their health and finances have been
totally destroyed beyond repair, they receive a “Ticket To Work”
packet in the mail, another waste of SSA funds. A cruel joke to
say the least and it is no wonder that they fear utilization of the
Ticket to Work Program, and distrust the Federal Government! The
Ticket to Work Program is often viewed as a carrot and stick it to the
disabled approach. I recommend in addition to the current Ticket
to Work Program, funding for the creation of an Interim (transitional)
SSDI disability program for those who are chronically ill, but still
may be able to work a few hours a week/month. They would apply
for interim disability benefits to start and for every month they
could not work they would get a full check. For any full month
or portion of a month that they could work they would be paid the
difference or nothing based on the amount of the SSDI benefit they
would earn by not working that month. They would be eligible for
full Medicare benefits from the onset. When their illnesses
progressed to a point that working is no longer an option, full SSDI
benefits would automatically kick in. This would continue to
increase benefits for the SSA trust fund, since these part time
workers would still be contributing to the fund.
Continuing
Disability Review/CDR Process Must Be Changed
Many people suffer from conditions acquired at birth or chronic
conditions that have NO cures and over time these diseases grow
progressively worse with no hope of recovery or ever returning to the
work force. The threat of possible benefits cut off, and stress
of a review by Social Security again is very detrimental to a
recipients health. This factor needs to be taken into
consideration when reforming the CDR process. In those cases
total elimination of the tedious medical component of CDR’s should be
considered, only requiring verification of contact info, or a longer
period of time between reviews such as 10-15 years rather then every
3-7 years, as is currently the case. This would save the SSA a
great deal of time, money and paperwork which could then be used to
get new claimants through the system faster.
Reform
Is Greatly Needed
Social Security, SSDI, SSI and Medicare are great programs when they
function properly, and have helped millions of Americans who may never
have survived without them. While it is too late for me, I have
vowed to make sure that nobody else has to endure this living
hell. Please contact your elected officials immediately to let
them know that this is unacceptable and that the laws must be
changed. I want to see new legislation created to reform the
Social Security Disability Program and I suggest that together the SSA
and Congress immediately set up a task force made up of claimants who
have actually gone through the SSDI system, that has major input and
influence on the decision making process before any final
decisions/changes/laws are instituted by the SSA Commissioner or
members of Congress. This is absolutely necessary, since nobody
knows better about the flaws in the system and possible solutions to
those problems, then those who are forced to go through it and deal
with the consequences when it does not function properly.
Congress also needs to legislate that Social Security funds cannot be
used for anything other than to pay out benefits and administer the
program. A country is only as strong as it’s most vulnerable
citizens and it’s time that the government fixes the problems, so that
those who really need this help can access it as soon as
possible. It is urgent that you contact your Congressional
representatives on this issue. Ask your elected officials
to introduce/support the Fullerton
-
Edwards Social Security Disability Reform Act
Permanent
Devastation Resulting From The SSDI Claims Process
Unbearable stress, severe depression and suicidal thoughts are very
common side effects of the disability claims process. I know
this not only from my own personal experience, but from thousands of
others that have contacted me to relate their personal experiences
with the SSDI claims process. The abuse and worry that
applicants are forced to endure, causes even further irreparable
damage to their already compromised health, and is totally
unacceptable. Due to the total devastation on their lives and
health as a result of the SSDI claims process, use of the SS Ticket to
Work program, or any future chance of possibly getting well enough to
return to the work force, even on a part time basis, becomes totally
out of the question. Plus there is always the stress of having
to deal with the SS Continuing Disability Review Process every few
years, where the threat of having your benefits suddenly cut off
constantly hangs over your head.
Many are under the mistaken notion that once the SSDI benefit checks
come, if one is finally approved for disability benefits, that
everything will be ok. Often the devastation caused while
waiting for SSDI claims to be processed leaves, permanent scars on
one’s health and financial wellbeing as it did for me. Even
though I won my case, I continually deal with enormous stress and face
the continued looming threat of bankruptcy and homelessness, due to
the cost of my healthcare and basic living expenses, and I still do
not qualify for any public assistance programs. After almost
dying, and continuing to battle several incurable diseases, I had to
wipe out all my life savings/pension money, and will never be able to
recover from the financial, physical and emotional devastation that
was caused, due to the enormous wait for my SSDI claim to be
processed. Due to the 24 month waiting period for Medicare, (I
didn’t become eligible for it until June 2004) I had to spend over
half of my SSDI check each month on health insurance premiums and
prescriptions, not including the additional co-pay fees on top of
it. All the SSDI retro pay is gone now as well – used to pay off
debts incurred while waiting for 1-1/2 years to get my benefits, and
even though I am now receiving my monthly SSDI checks benefits, they
are no where near enough to live on for the rest of my life.
I have no hope for the future and my “American Dream” has quickly
turned into the “American Nightmare” through no fault of my own. It is
hard enough to deal with all the illnesses that I have, but then to
have my entire life destroyed with the stroke of pen by a neglectful
government employee, to whom I was just an SS number, is more than I
can bear. So now, not only will I never recover from my
illnesses, but now I also will never recover from the permanent
financial devastation this has had on my life. I don’t know how
I am going to survive without some miracle like winning the
lottery. I am now doomed to spend what’s left of my days here on
earth, living in poverty, in addition to all my medical
concerns. I will never be able to own a home, or get another
car. My current vehicle which is on death’s door, is the ONLY
method of transportation I have for survival. When things break
down now, I cannot fix them and have to do without, and more things
are breaking down every day! This totally unbearable, continuing
source of stress and frustration, is killing me. As you can see,
I know from personal experience the pain and poverty that this
problematic system can cause. I did not ask for this fate and
would trade places with a healthy person in a minute. Nobody
ever thinks it can happen to them. I am proof that it can, and
remember disease and tragedy do not discriminate on the basis of age,
race or sex. If you think this could not happen to you – you
could be DEAD wrong!
WARNING:
I alert you to the case of Dane Edwards from the Rochester NY area who
applied for Social Security Disability benefits in October 2006,
because of terminal lung and brain cancer. When he’d call to
check on the status of his claim he was told that he must wait like
everyone else, and that he should stop calling to inquire about the
status. He obviously didn’t have the luxury of time.
Dane will no longer be calling and he never received his
benefits. The last precious, few months of his life were spent
in anger and frustration, fighting a system, which in the end failed
him miserably. He was 53 years old when he died on February 13,
2007 - his SSDI disability claim still waiting for approval.
Unfortunately I must report that stories like his are becoming more
and more common.