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.