Later On

Look at this mess. Of course, these people are mostly poor, so the GOP doesn’t care.

Steadily lengthening delays in the resolution of Social Security disability claims have left hundreds of thousands of people in a kind of purgatory, now waiting as long as three years for a decision.

Two-thirds of those who appeal an initial rejection eventually win their cases.

But in the meantime, more and more people have lost their homes, declared bankruptcy or even died while awaiting an appeals hearing, say lawyers representing claimants and officials of the Social Security Administration, which administers disability benefits for those judged unable to work or who face terminal illness.

The agency’s new plan to hire at least 150 new appeals judges to whittle down the backlog, which has soared to 755,000 from 311,000 in 2000, will require $100 million more than President Bush requested this year and still more in the future. The plan has been delayed by the standoff between Congress and the White House over domestic appropriations.

There are 1,025 judges currently at work, and the wait for an appeals hearing averages more than 500 days, compared with 258 in 2000. Without new hirings, federal officials predict even longer waits and more of the personal tragedies that can result from years of painful uncertainty.

Progress against the backlog, if it happens, cannot undo the three years that Belinda Virgil of Fayetteville has worried about her future since her initial application was turned down. Tethered to an oxygen tank 24 hours a day because of emphysema and life-threatening sleep apnea, Ms. Virgil lost her apartment and has alternated between a sofa in her daughter’s crowded house and a friend’s place as she waits for answer to her appeal.

“It’s been hell,” said Ms. Virgil, 44, who finally got her hearing in November and is awaiting the outcome. “I’ve got no money for Christmas, I move from house to house and I’m getting really depressed,” she said.

The disability process is complex and the standard for approval has, from the inception of the program in the 1950s, been intentionally strict to prevent malingering and drains on the Treasury. But it is also inevitably subjective in some cases, like those involving mental illness or pain that cannot be tested.

In a standard tougher than those of most private plans, recipients must prove that because of physical or mental disabilities they are unable to do “any kind of substantial work” for at least 12 months — if an engineer could not do his job but could work as a clerk, he would not qualify — or an illness is expected “to result in death.”

In a recent interview, the commissioner of Social Security, Michael J. Astrue, said that outright fraud was rare but that many cases on appeal were borderline. In addition, widely publicized charges in the 1970s that money had been wasted on recipients whose conditions improved led to tighter scrutiny.

Of the roughly 2.5 million disability applicants each year now, about two-thirds are turned down initially by state agencies, which make decisions with federal oversight based on paper records but no face-to-face interview. Most of those who are refused give up at that point or after a failed request for local reconsideration.

But of the more than 575,000 who go on to file appeals — putting them in the vast line for a hearing before a special federal judge — two-thirds eventually win a reversal.

Mr. Astrue and other officials attribute the high number of reversals to several causes. Those who file appeals tend to be those with stronger cases and lawyers who help them gather persuasive medical data. During the extended waiting period, a person’s condition may worsen, strengthening the case. The judges see applicants in person, and have more discretion to grant benefits in borderline cases.

Requiring face-to-face interviews at the initial stage could reduce the number of appeals, Mr. Astrue said, “but given the huge volume of cases coming through, it would be incredibly costly and the Congress is not willing to fund that.”

The growing delays in the appeal process over the last decade resulted in part from litigation and financing shortages that prevented the hiring of new administrative law judges. In addition, applicants are rising as baby boomers reach their 50s and 60s.

More at the link.