The Social Security Administration is overwhelmed by disability claims.

http://www.sptimes.com/News/041501/TampaBay/Disabled_can_wait_yea.shtml

By CURTIS KRUEGER
© St. Petersburg Times, published April 15, 2001

Anna Bell had worked as a nurse and as a security guard, but over the years her epilepsy grew more and more debilitating. Her seizures came three, sometimes five times a day. Her hands shook from multiple sclerosis.

So Bell, like millions of other workers suffering illness or injury, applied to the Social Security Administration for disability benefits. It took an agonizing seven years before an administrative law judge approved her claim.

"It was like a nightmare, a nightmare that never should have happened," said Bell, 57, who lives in St. Petersburg with her 26-year-old son, Donnie, and now receives a $530 monthly check.

Social Security's disability programs last year supported more than 10-million Americans with more than $80-billion. In the current fiscal year, a government report says spending on disability benefits could amount to 5 percent of the federal budget.

But complaints like Bell's are frequent. The system is so overwhelmed with claims that waits of two years are common. Often, people who apply are told to expect to be turned down at first and gear up for a lengthy appeal. Mistakes are not unheard of. In the meantime, aging baby boomers are likely to flood the system, and some experts say the current bureaucracy simply can't handle it.

This growth "threatens to overwhelm a policy and administrative infrastructure that is already inadequate to meet the needs of the public," said a report issued earlier this year from the Social Security Advisory Board, a bipartisan, independent monitor established by Congress.

The board called for fundamental changes to the system, because people in some areas of the country appear more likely to get benefits than in others; the decisionmaking process is convoluted; and the system does not provide many incentives for disabled people to return to work.

Many in the Tampa Bay area say they have experienced these problems and see the need for reforms, although not everyone has to wait years for benefits.

Suffering from AIDS, Clifford Ruffin said he applied for disability benefits and received them in about a month. People with AIDS and other terminal illnesses have their claims expedited, under federal rules. Ruffin, 43, of St. Petersburg, also is grateful to the VA Medical Center at Bay Pines for shepherding him through the process, although he adds, "I'd much prefer to be back on my job," making roofing materials.

Not everyone sees major problems with the process. "I don't see that the system is broken; I don't see that the system is difficult. I do see that there are a lot of differences in how you interpret medical reports," said Donald C. Anderson, a St. Petersburg lawyer who handles Social Security disability cases.

But lawyer Stephan J. Freeman said, "I see mistakes all the time. I see a lot of loss of documents, one hand not knowing what the other hand is doing."

He is quick to say he also encounters many dedicated employees at the Social Security Administration and that "overall they do a good job and they do a service. I think they could do even a better job if they had more money from Congress."

Disability benefits are designed for people unable to work because of sickness or injury. People who apply for benefits make a claim that is reviewed by specialists employed by the state. If the claim is rejected, these specialists can review the file a second time. If it's turned down again, the claim can be appealed to an administrative law judge.

The process takes time, because no one wants benefits to go to those who don't qualify. But Freeman said getting through the appeal stage takes at least 18 months, and can take two to three years. That's eons for anyone truly unable to work.

While waiting for benefits, people struggle to scrape by. "They may sell their things; they beg basically. Go to the homeless shelter, go to St. Vincent De Paul to eat," Freeman said.

Bell said she forced herself to work even when she felt she was really unable to. More than one employer let her go after she went into seizures on the job, she said.

Mark Hinkle, spokesman for the Social Security Administration, said the agency is trying to streamline its process. In 10 states, not including Florida, Social Security has given more decisionmaking authority to the people who make the first review of claims, and eliminated the second review. That makes a quicker path to an appeal. The agency intends to take the program nationwide by 2003.

He said the independent Social Security Advisory Board's recent report "certainly has raised issues that are out there. I don't think it's things that we haven't known about."

One of the report's criticisms is that states differ widely in how the federal program is administered.

Consider that in New Hampshire, 58.8 percent of the people who applied for a benefit called Supplemental Security Income were successful in their initial application, compared with 28 percent in Arkansas and Mississippi. In Florida, 42.1 percent of applicants succeeded, above the national average of 37.8, according to data provided by the board. This program, known as SSI, goes to needy elderly, blind or disabled people, regardless of work history.

The success rate also was all over the map in the Social Security Disability Insurance program, which pays based on previous employment covered by Social Security. Approval rates ranged from 65.3 percent in New Hampshire to 30.9 percent in Texas. In Florida, 38.4 percent of applicants succeeded, below the national average of 44.6.

So what happens when people are turned down, and appeal to an administrative law judge?

All over the map again. Compare New Hampshire, where 80.9 percent of the people won on appeal for both programs, to Hawaii, at 35.5 percent. In Florida the figure was 68.8 percent, above the national average of 64.4.

"A primary reason why the disability programs do not share the same level of public confidence as the retirement program is the perception that determinations of eligibility for disability are not being made in a uniform and consistent manner," the report said.

The report also states that the disability programs were established when manual labor was the norm, and disabled people often could not rejoin the work force. The system needs better incentives to help people return to work, the report said.

The issue could get more scrutiny in Congress. "We actually are planning an in-depth hearing on the disability process," said Kim Hildred, staff director of a U.S. House subcommittee on Social Security headed by Rep. Clay Shaw, R-Fort Lauderdale.