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Members of the Committee:
My name is Linda Fullerton,
and I currently receive Social Security Disability Insurance/SSDI and
Medicare. I have an inoperable blood clot and tumor in my brain, and several
incurable autoimmune disorders, which have caused me to become permanently
disabled. Social Security Disability is an insurance policy which was created
to be a safety net for millions of disabled Americans, and for many such as
myself, it has become their only lifeline for survival. I have personally
suffered from the affects of the severe hearing backlogs (Buffalo NY OHA), due
to the enormous waiting time I endured, and I am very discouraged to know that
conditions are continuing to decline. 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 lost all my resources, life
savings, and pension money during the 1-1/2 year wait for my SSDI claim to be
processed. I know first hand about the pain, financial, physical and emotional
permanent devastation that the SSDI process can cause. My “American Dream”
will never be realized. I have now been forced to live the “American
Nightmare” for the rest of my days, because I happened to get sick, and file a
claim for Social Security Disability benefits, a Federal insurance policy that
I paid into for over 30 years. As a result, I will never be able to own a
home, replace my lost financial resources, or replace my only means of
transportation – a failing 11 year old car, and several other necessities that
have now broken down. I currently live strictly on the inadequate, monthly
SSDI check I receive, teetering on the brink of disaster. 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. When things break down now, I cannot fix them and
have to do without. I struggle every day to pay for food, medicines,
healthcare, gas etc, and this totally unbearable, continuing source of stress
and frustration, along with my worsening health conditions, is killing me. I
did not ask for this fate and Congress and the SSA are totally responsible for
it. My personal horror stories can be found on my websites at:
A Bump On The Head
http://www.frontiernet.net/~lindaf1/bump.html
Social Security Disability
Nightmare – It Could Happen To You!
http://www.frontiernet.net/~lindaf1/SOCIALSECURITYDISABILITYNIGHTMARE.html
Please
know that in spite of my horrible experience, I am committed to joining forces
with Congress and the SSA to fix the problems with this disability benefits
program. I am devoting whatever is left of my life to make sure that nobody
else will ever have to endure the hell that I have been forced to live with
every day, and I hope you will join me in that quest. I also ask that you
forgive the harshness in the tone at times of the this testimony, but I feel it
is the only way to fully, and accurately describe the severity of this issue.
It is also important to note
that I am also President/Co-Founder of the Social Security Disability
Coalition, which is made up of thousands of Social Security Disability
claimants and recipients from all over the nation, and our membership increases
by the day. It was born out of my frustration with my own experience and the
notion that others may be dealing with that same frustration. Our group is a
very accurate reflection and microcosm of what is happening to millions of
Social Security Disability applicants all over this nation. If you visit the
Social Security Disability Coalition website, or the Social Security Disability
Reform petition website:
Social Security Disability
Coalition – offering FREE information and support with a focus on SSD reform:
http://groups.msn.com/SocialSecurityDisabilityCoalition
Sign the Social Security
Disability Reform Petition – read the horror stories from all over the nation:
http://www.petitiononline.com/SSDC/petition.html
You will read over five years
worth of documented horror stories on our Messageboard (over 18,000 messages),
and see thousands of signatures (over 7600) and comments on our petition, from
disabled Americans whose lives have been harmed by the Social Security
Disability program. You cannot leave without seeing the excruciating pain and
suffering that these people have been put through, just because they happened
to become disabled, and went to their government to file a claim for disability
insurance that they worked so very hard to pay for. I must take this
opportunity to tell you how very proud I am of all our members, many like
myself, whose own lives have been devastated by a system that was set up to
help them. In spite of that, they are using what very little time and energy
they can muster due to their own disabilities, to try and help other disabled
Americans survive the nightmare of applying for Social Security Disability
benefits. There is no better example of the American spirit than these
extraordinary people!
This organization fills a
void that is greatly lacking in the SSDI/SSI claims process. While we never
represent claimants in their individual cases, we are still able to provide
them with much needed support and resources to guide them through the nebulous
maze that is put in front of them when applying for SSDI/SSI benefits. In
spite of the fact that the current system is not conducive to case worker,
client interaction other than the initial claims intake, we continue to
encourage claimants to communicate as much as possible with the SSA in order to
speed up the claims process, making it easier on both the SSA caseworkers and
the claimants themselves. As a result we are seeing claimants getting their
cases approved on their own without the need for paid attorneys, and when
additional assistance is needed we connect them with FREE resources to
represent them should their cases advance to the hearing phase. We also
provide them with information on how to access available assistance to help
them cope with every aspect of their lives, that may be affected by the
enormous wait time that it currently takes to process an SSDI/SSI claim. This
includes how get Medicaid and other State/Federal programs, free/low cost
healthcare, medicine, food, housing, financial assistance and too many other
things to mention here. We educate them in the policies and regulations which
govern the SSDI/SSI process and connect them to the answers for the many
questions they have about how to access their disability benefits in a timely
manner, relying heavily on the SSA website to provide this help. If we as
disabled Americans, who are not able to work because we are so sick ourselves,
can come together, using absolutely no money and with very little time or
effort can accomplish these things, how is it that the SSA which is funded by
our taxpayer dollars fails so miserably at this task?
Social Security Disability
Claimants Face Death And Destruction When Applying For Benefits
I must report with great
sadness and disgust, that there is blood and destruction on the hands of both
the Social Security Administration and Congress. Both have been systematically
killing and devastating the lives of the most vulnerable citizens of this
nation for decades. I firmly believe (while nobody from the SSA or Congress
will ever admit this), the Social Security Disability program is structured to
be very complicated, confusing, and with as many obstacles as possible, in
order to discourage and suck the life out of claimants, hoping that they “give
up or die” trying to get their SSDI benefits!
During 2006 and 2007, at
least 16,000 people fighting for Social Security Disability benefits died while
awaiting a decision (CBS News Report – Disabled And Waiting - 1/14/08). NOTE:
This is more than 4 times the number of Americans killed in the Iraq war since it began.
During 2007, two-thirds of
all applicants that were denied - nearly a million people - simply gave up
after being turned down the first time (CBS News Report – Failing The Disabled
- 1/15/08)
In 2007 there were
2,190,196 new applications for SSDI benefits, and as of March 2008 there have
already been 563,769 new applications.
As of April 2008 there are
about 1,327,682 total pending cases and out of that number, 154,841 are
veterans.
Nationally as of March
2008, over 64% of disability cases were denied at the initial stage of the
disability claims process and it took from 104.5 – 114. days for claimants to
receive the initial decision on their claim.
If a claimant appeals the
initial denial asking for reconsideration, in all but 10 test states where the
reconsideration phase has been removed, 86.5% of cases were denied and the
waiting time for this phase was an average of 88.8 days.
As of April 2008 over
756,000 are waiting for hearings with an average wait time of 517 days
As of April 2008 over
286,000 (38 %) hearings have already been pending over a year, and there are
only 951 Administrative law judges (ALJ’s), to hear all those cases, with an
average of 738.02 cases pending per judge nationwide.
Source: Social Security
Administration Reports
Two-thirds of those who
appeal an initial rejection eventually win their cases (New York Times
12/10/07)
According to Health
Affairs, The Policy Journal of the Health Sphere, 2 February 2, 2005:
Disability causes nearly 50% of all mortgage foreclosures, compared to 2%
caused by death.
MarketWatch: Illness And
Injury As Contributors To Bankruptcy - February 2, 2005 – found that: Over
half of all personal U.S. bankruptcies, affecting over 2 million people annually,
were attributable to illness or medical bills. 15% of all homeowners who had
taken out a second or third mortgage cited medical expenses as a reason.
According to an insurance
survey, conducted by the International Communications Research of Media, PA from Jan 10-14th 2007, on behalf of the National Association of Insurance
Commissioners, researchers found 56% of U.S. workers would not be able pay
their bills or meet expenses if they become disabled and unable to work. 71%
of the 44% who had insurance, stated it was employer provided, so if they lose
or change jobs they would no longer have disability coverage.
In April 2006, Parade
Magazine in an article called “Is The American Dream Still Possible?” -
published the results of their survey of more than 2200 Americans who earned
between $30,000 and $99,000 per year, most stating that they were in reasonably
good health. 66% say they tend to live from paycheck to paycheck and nearly
83% say that there is not much money left to save after they have paid their
bills.
Other Important Disability
Statistics:
Nearly 1 in 2 (133
million) Americans live with a chronic condition.
20.6% of the population,
about 54 million people, have some level of disability
9.9% (26 million people)
have a severe disability
Note: The sources for
these statistics and even more information is listed here:
http://www.mychronicillness.com/invisibleillness/statistics.htm
This is totally unacceptable
and there is absolutely no excuse for this!
On behalf of the Social
Security Disability Coalition, our response to Congress and the SSA for this
situation is:
For everyone of us that starves, becomes homeless or loses our healthcare during this process – we blame you!
For everyone of us who files for bankruptcy during this process – we blame you!
For the unfathomable stress and suffering we have inflicted upon us during this process – we blame you!
For everyone of us who
becomes more ill or worse yet dies during this process – we blame you!
Horrendous Customer Service On The Part Of
SSA And Congress
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.
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. 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 results and 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.
Congressional offices as part
of their functions, contact Social Security on behalf their constituents going
through the SSDI process all the time, so you must be fully aware of all the
problems, and are the ones who can help correct many of them. I find it
incredulous that almost nothing has been done 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 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, negligent attitude towards this crisis must be changed
immediately. I am sad to say that you have failed us miserably, doing us a
grave injustice in this area. It’s time that you speak out about the crimes
being committed against your 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.
Permanent Devastation Resulting From The
SSDI Claims Process
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. 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.
Call For Open
Congressional/SSA Disability Hearings
I also find it deeply
disturbing, and glaringly obvious, that at this latest hearing, and at past
hearings over the last several years on this issue, that not one
panelist/witness selected to appear, has been a disabled American, and one who
has actually experienced this nightmare first hand. Something is severely wrong
with that picture! You continually choose the same panelists from the legal,
disability advocate community etc when there is any representation at all.
Unless you personally have experienced these problems yourself, you cannot even
begin to fully understand how devastating they really are, and therefore are
not fully qualified to be the only authority on these issues. It is my
understanding that there are also those within the SSA itself, who have wanted
to testify for several years, and until recently have also been shut out of
these hearings as well. In my opinion, it seems that you don’t want to know
what is really going on. If you don’t actually have to face us in person, we
remain a bunch of SS numbers whose lives can be destroyed without guilt. We
are in fact, your mothers, fathers, sisters, brothers, children, grandparents,
honorable veterans who have served this country, your friends and neighbors.
How you get an accurate
handle on this situation without all the facts and possible witnesses who wish
to testify in person? I find it hard to believe that these hearings cannot be
scheduled in such a way that more appropriate witnesses could be chosen to
testify. As an actual disabled American, I ask again as I have in the past,
that in future Congressional hearings on these matters, that I be allowed to
actively participate instead of being forced to always submit testimony in
writing, after the main hearing takes place. I often question whether anybody
even bothers to read the written testimony that is submitted when I see the
results of hearings that were held in the past. I am more than willing to
testify before Congress, to risk my very life for the opportunity, and I should
be permitted to do so. I want a major role in the Social Security Disability
reformation process, since any changes that occur have a direct major impact on
my own wellbeing and that of our members. Who better to give feedback at these
hearings than those who are actually disabled themselves, and directly affected
by the program’s inadequacies! A more concerted effort needs to be utilized
when scheduling future hearings, factoring in enough time to allow panelists
that better represent a wider cross section of disabled Americans, to testify
in person. It seems to me if this is not done, that you are not getting a
total reflection of the population affected, and are making decisions on
inaccurate information, which can be very detrimental to those whom you have
been elected to serve. I also propose that Congress immediately set up a task
force made up of SSDI claimants, such as myself, 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.
There are three key reasons why the Social Security
Disability program has been broken for decades, lack of proper funding for the
SSA, apathy on the part of Congress and the SSA to fix the problems, and lack
of oversight on all crucial parts of the program.
SSA Commissioner
Improperly Allocates ALJ's For SS Disability Hearings
Recently SSA Commissioner
Michael Astrue asked Congress to approve extra funding in order to hire
additional ALJ’s to try and reduce the severe SS Disability hearings backlogs
across the country. While I agree that the SSA does need more funding, in fact
way more than was actually finally given to them, there must be some major
oversight by independent entities to ensure that these funds in fact are
actually used/allocated appropriately. Here is a recent example that raises a
red flag for such oversight and an immediate investigation. At the link below
you will find a spreadsheet that shows the locations where the newly acquired
ALJ announced by the SSA Commissioner have been allocated
As of March 2008:
It takes 669 days (nearly two
years) for the average Western New Yorker to have their SSA case heard and
processed in the Buffalo Hearing Office. This office is the worst in NY State
for SS Disability hearing backlogs and out of 145 hearing offices nationwide, Buffalo ranks at 126, as one of the worst processing times in the country.
It ranks at 111 out of 145
hearing offices, at 47%, for the number of SSA hearings SSA cases in the
Buffalo Hearing Office have been pending for over a year, among the highest
percentages in the country.
Administrative Law Judges in Buffalo have some of the largest caseloads in the country, with an average of 895 cases
pending before each judge.
Source: Compiled from various SSA reports
March 2008
Commissioner Astrue used the
Argument that there was not enough office space in the Buffalo hearing office
but that was immediately refuted by Congressman Brian Higgins:
Congressman Higgins Says
Lack of Space Is Poor Argument for Staffing Shortfalls in Local Social Security
Disability Office – 4/24/08
http://higgins.house.gov/newsroom.asp?ARTICLE3116=7715
“If the problem is office
space, I would be happy to find them available space in downtown Buffalo tomorrow,” Higgins added, pointing out that according to a Militello Realty report
on downtown Buffalo property, as of January 779,228 square feet of Class A
office space was vacant in the immediate downtown area. Congressman Higgins
noted that staffing shortages aren’t exclusive to the Administrative Law
Judges. Staffing at Western New York field offices have decreased
substantially – by approximately 170 employees - over the past 25 years, even
though the need for services has increased.”
How many other states is this happening to?
Where is the much needed oversight on this issue?
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 under staffing 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 and other even worse breaches
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).
States Of Denial - Federalize State DDS Offices
Since Social Security
Disability is a Federal program, where you live should not affect your ability
to obtain benefits. Sadly this is not the case. The only way to solve this
inconsistency is to Federalize the State DDS’s and we are in agreement with
AFGE on this. The first problem that must be addressed, and major cause for
the huge backlog of disability hearing claims, is the overwhelming denial rate
at the initial DDS level of the claims process. If claims were processed
properly at this stage of the process there would be no need for the claimant
to appeal to the ALJ hearing phase in the first place, and that would be a huge
factor in reducing the hearing backlogs. It seems that this fact has been
greatly ignored.
The SSDI/SSI process is bogged
down with tons of paperwork for both claimants and their treating physicians,
and very little information is supplied by Social Security, as to the proper
documentation needed to process a claim properly and swiftly. When you file a
claim for benefits, you are not told that your illness must meet standards
under the Disability Evaluation Under Social Security “Blue Book” listing of
medical impairments, or about the Residual Functional Capacity standards that
are used to determine how your disability prevents you from doing any sort of
work in the national economy, or daily activities, when deciding whether or not
you are disabled. In other words since the process is so nebulous from
beginning to end, the deck is purposely stacked against a claimant from the
very start. Many times when medical records are supplied by the claimant, they
are lost or ignored.
Excerpts from GAO Report
GAO-04-656 – SSA Disability Decisions: More Effort Needed To Assess Consistency
of Disability Decisions – Washington – July 2004 which can be found at:
http://www.gao.gov/new.items/d04656.pdf
“Each year, about 2.5 million
people file claims with SSA for disability benefits...About one-third of
disability claims denied at the state level were appealed to the hearings level;
of these, SSA’s ALJ’s have allowed over one-half, with annual allowance rates
fluctuating between 58 percent and 72 percent since 1985. While it is
appropriate that some appealed claims, such as those in which a claimant’s
impairment has worsened and prohibits work, be allowed benefits,
representatives from SSA, the Congress, and interest groups have long been
concerned that the high rate of claims allowed at the hearing level may
indicate that the decision makers at the two levels are interpreting and applying
SSA’s criteria differently. If this is the case, adjudicators at the two
levels may be making inconsistent decisions that result in similar cases
receiving dissimilar decisions.”
“Inconsistency in decisions
may create several problems... SSA rulings are binding only on SSA adjudicators
and do not have to be followed by the courts...Adjudicators currently follow a
detailed set of policy and procedural guidelines, whereas ALJ’s rely directly
on statutes, regulations, and rulings for guidance in making disability
decisions...If deserving claimants must appeal to the hearings level for
benefits, this situation increases the burden on claimants, who must wait on
average, almost a year for a hearing decision and frequently incur extra costs
to pay for legal representation...SSA has good cause to focus on the
consistency of decisions between adjudication levels. Incorrect denials at the
initial level that are appealed increase both the time claimants must wait for
decision and the cost of deciding cases. Incorrect denials that are not
appealed may leave needy individuals without a financial or medical safety
net...
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. Also since there is a different pay scale for government vs state
employees who are often underpaid, lack training, are overworked, and must meet
quotas of cases processed, the tendency is greater to rubber stamp denials to
move it off their desk when a case need too much development. Thus the
explanation for the fluctuation in denial/approval/backlog rates by state.
Unfortunately there is very little if any training or oversight on the state
DDS offices to make sure they are making the proper decisions on disability
claims. This is why so many claimants appeal to the hearing level where a huge
percentage of bad claims decisions are overturned and cases are finally
approved. Anyone who doesn’t see that a “Culture Of Denial” has become a
pervasive part of an SSDI claimants encounter with the SSA, is either totally
out of touch with reality or is reacting evasively to the subject.
Social Security Disability Program Problems
- Contributing Burden Factor on Medicaid/Social Service Programs For States
There seems to be a
relationship, between SSDI claims processing issues/backlogs, and the need for
claimants to also apply for state funded Medicaid/Social Service programs.
Many are forced to file for Medicaid, food stamps and cash assistance, another
horrendous process. Those who file for these programs while waiting to get
SSDI benefits, in many states, have to pay back the state out of their meager
benefit checks once approved. As a result they’re often kept below the poverty
level, almost never able to better themselves since they can’t work, and now
are forced to rely on both state and federally funded programs instead of just
one of them. This practice should be eliminated.
Improper CE/IME Medical Exams Ordered By
Social Security Result In Higher Rate Of Denials/Appeals
CE/IME examiners are paid a
fee by Social Security for each person they see, so the more claimants they
process, the more money they make. Often times they are caught saying they
performed exams that they in fact never performed, or make mistakes, even false
statements about claimants. Many times the DDS offices or ALJ’s are sending
claimants to doctors that have very limited knowledge of their specific health
conditions, who are not specialists, or even the proper type of doctor, to be
examining a claimant for the type of medical conditions that they have. Even
though a claimant’s treating physicians are supposed to be given greater weight
in decision making, this is often not the case. These doctors see you once for
a few minutes, and yet their opinion is given greater authority than a claimant’s
own treating physician who sees them in a much greater capacity? Something is
way out of line with that reasoning, yet it happens every day. It therefore
results in a waste of time, money and energy, for both the claimants and the
SSA, when the claimant ends up appealing a denial based on these improper SSA
ordered examinations.
Detrimental Regulations
There are some very
detrimental, regulations that SSDI applicants are subject to as well, and are a
great shock to them. 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 it is assumed that disabled Americans 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. In my state when a healthy
person loses their job, provides the necessary documents and files for
Unemployment Insurance, their payments automatically start within a few weeks.
It is blatantly obvious that those who find this to be acceptable standards are
totally out of touch with reality and have no regard for human life.
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.
Eliminate Need For Proposed Third Party
Claims/Paid Legal Representation
First of all the SSDI claims
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. I feel strongly that an
SSDI claimant should not have to pay for legal representation to get benefits
that they have already paid for with their taxes. I am also highly opposed to
the possibility of a claimant having to pay a third party for assistance to
file a claim at the onset. Congress must intervene immediately to prevent this
from happening, and in fact change the law that the claimant has to pay for
legal representation at all. This adds an additional financial burden to the
claimant. 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 SSD 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. The SSA should instead provide claimants with access
to FREE resources that can help in the process of filing SSDI claims and keep
the legal community out of it.
Americans Most Sensitive
Data In Jeopardy
The following article
discusses the SSA employee work at home situation.
Concern Over Federal Times
Article: Arbitrator Tells SSA To Restore Telework, Negotiate Changes – Federal
Times - Courtney Mabeus – 4/16/08
http://www.federaltimes.com/index.php?S=3482166
I am very concerned with the
increased possibility of identity theft if SSA employees are allowed to take
work home because they are too overloaded on their jobs. Employees should
never be allowed to take this sensitive data home for any reason. Sensitive
data has already been compromised at the VA, and this should not be allowed to
happen ever again, especially jeopardizing our most vulnerable citizens to this
very real and stressful possibility. I have personally caught the SSA in some
major security breaches already, and this practice will only make those
incidents even more common. Every effort must be made to properly secure this
most sensitive information for the American people. In order to properly
protect citizen's identities ALL sensitive data should only be able to be
accessed on government secure systems at the job site only. This is obviously
going to require more manpower and financial resources, and Congress must make
sure that the SSA has every resource it needs to protect this data, at their
disposal immediately.
Influx Of Improper SS Disability Claim
Filings Due To State And Private Insurance Company Policies
There is a growing number of
claims being filed by people who may not actually qualify for disability
benefits under SSDI guidelines, but are being forced to file SSDI claims by
their private disability and state disability carriers or risk not being
eligible for benefits under those programs. Recently there was an article on
this issue in the NY Times which can be found here:
Insurers Faulted As
Overloading Social Security – NY Times – Mary Williams Walsh – 4/1/08
http://www.nytimes.com/2008/04/01/business/01disabled.html
Congress and the SSA
needs to immediately look into this issue and this practice needs to be stopped
immediately as this greatly adds to the disability backlog problem.
Reinstate DCM
Currently, the most crucial
part of a disability claim, the medical portion, is reviewed by a state DDS
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 make a
critical life changing decision as to whether or not they feel you are disabled
based on the information that you and your doctors have provided. It is
absolutely necessary for a claimant to be able to communicate with the decision
maker and to be able to provide updated information on their medical
conditions, especially before a decision is made on a claim. It is common
sense, that proper communication at the initial level, would definitely result
in a reduction of appeals at all further levels of a disability claim. The
high decision reversal rate at the hearing (ALJ) level is concrete proof of
that. It is recommended that the Disability
Claims Manager (DCM) pilot, where DCMs were responsible for making both the
entitlement and disability decisions for initial disability claims, be reinstated,
and eventually extended to the entire country. With proper staffing to allow
for communication between decision maker and claimant, this would definitely
result in time and cost savings, for both the SSA and the claimants if this
were reinstated.
Excerpts from GAO Report
GAO-04-656 – SSA Disability Decisions: More Effort Needed To Assess Consistency
of Disability Decisions – Washington – July 2004 which can be found at:
http://www.gao.gov/new.items/d04656.pdf
An appeal adds significantly
to costs associated with making a decision. According to SSA’s Performance and
Accountability Report for fiscal year 2001, the average cost per claim for an
initial DDS disability decision was about $583, while the average cost per
claim of an ALJ decision was estimated at $2,157...An appeal also significantly
increases the time required to reach a decision. According to SSA’s
Performance and Accountability Report for fiscal year 2003, the average number
of days that claimants waited for an initial decision was 97 days, while the
number of days they waited for an appealed decision was 344 days.
Changes/Proper Funding Necessary For SSA
SSA should not have to
compete each year for funding with the Departments of Labor, HHS and Education
which are more publicized and often popular programs. As stated in the
previous testimony provided by Witlold Skierwczynski – President – National
Council Of Social Security Administration Field Operation Locals to this
committee on 4/23/08 it is recommended that:
Congress
should enact off budget legislation including SSA administrative expenses with
benefits which are already off budget. Congress should retain appropriations
and oversight authority albeit unencumbered by artificial budget caps and
scoring restrictions.
Congress should enact
legislation requiring the Commissioner to submit the SSA appropriation request
directly to Congress.
Congress
should support the House Budget Committee recommendation to increase the SSA
administrative budget by $240 million over the President’s budget request.
Concern Regarding SSA’s Future Movement Away
From Personalized Customer Service
I totally disagree with the
agency's goal of eliminating an SSA employee to assist with the filing of a
claim. I am very concerned about recent changes that emphasize the use of the
internet for filing Social Security Disability claims. In fact I always urge
our members to file in person rather than use the internet to file their
disability claims. Many disabled Americans do not have access to the internet
or their disabilities prevent them from using it properly. This can result in
improper filing of a claim and delay or result in a denial of benefits. Since
we encourage our members to provide as much medical information as possible to
the SSA at the initial filing of their claim in order to speed up the process,
it is impossible to provide this information if a claimant chooses to use the
internet instead. I agree with previous testimony provided by Witlold
Skierwczynski – President – National Council Of Social Security Administration
Field Operation Locals to this committee on 4/23/08, that here are several
flaws with this proposed movement as follows:
Programming flaws that do not
correctly identify the “protected filing date/disability date of eligibility.”
Identity and privacy concerns
Incorrect payments
High volume of errors,
resulting in re-contacts.
Creation of a new backlog at
Social Security
No review process of the
public’s accuracy in completing applications
I am very concerned about the
loss of protected filing for internet claims and this should never be allowed.
This could result in a major loss of much needed benefits which is not
acceptable. Immediate efforts must be made to look into and correct this
situation.
Lag
earnings must also continue to be properly developed so that a claimant’s wages
can be easily added to the benefit computation at the initial interview and to
make sure that proper payments are made to claimants right from the start. The
encouragement of internet claims filing will make this almost impossible. This
will cause a dramatic increase in improper payments, and unnecessary wasted
time for both the claimants and SSA resources.
I am totally against the
implementation of the Accept Allegation
of Month of Entitlement - Effective September 2008. The majority of the
general public, and especially Americans with disabling conditions, are in no
way knowledgeable enough to properly make this life altering decision without
full disclosure and human assistance. This again will cause many unnecessary
under and over payments and could result in permanent harm to disability
claimants.
The American people must
always be given the option to file their claims using whatever method best
suits their capabilities, and be ensured that the results will be accurate and
in their best interest, no matter what option they choose. It must become
mandatory that every internet claim submitted, must be fully reviewed and
followed up by personal contact between an SSA employee and the claimant to
ensure its total accuracy. Every effort must be made on the part of the SSA to
continue provide personal customer service to the most vulnerable citizens of
this nation. Anything less than that is unconscionable and totally unacceptable.
Unacceptable Office
Closures
I am very discouraged by the
number of SSA Office closures that I continually hear about. It is another
example of poor customer service to the American people when the need for that
service is only going to increase over time as the population ages. In fact a
record number of offices were closed in 2007 and more closures are on the
horizon. This puts more stress and strain on the health of disability
applicants, and increased financial burden, when they have to travel several
miles just to do business with Social Security. They often have to wait months
for claim processing appointments, and have to stand in lines for hours as well
when they can get to the nearest SS office at all. There is no good excuse for
this. Where is the oversight?
I support the Social Security Customer Service Improvement Act,
H.R.5110, which was introduced by Representative Brian Higgins (D/NY), on
January 24, 2008, which contains procedures that the SSA Commissioner must
follow before closing an office. I urge Congress to quickly pass this proposed
legislation and pass additional legislation putting a moratorium on all office
closures, before more disabled Americans are harmed and inconvenienced.
I highly recommend that for
the best, most efficient customer service to the American people, that ALL SSA
operations be Federalized, and that ALL phases of the Social Security
Disability program, initial decisions, reconsiderations, hearings and appeals
be moved to, and handled out, of the individual field offices throughout the
country. I also recommend that more offices be opened to properly serve the
public and to implement the changes properly.
The Nightmare Continues -
Excerpts From Social Security Administration: Inadequate Administrative Funding
Contributes to the Disability Claims Backlog Crisis and Service Delivery
Challenges - Prepared by the National Council of Social Security Management
Associations (NCSSMA) March 13, 2008
Due to budget constraints in
recent years the amount of administrative funding the Social Security
Administration (SSA) has received through the appropriations process has been
significantly below the level necessary to keep up with the agency’s workloads.
As a result, the backlog of
unprocessed disability claims has grown to unprecedented levels and the system
is now in a state of crisis. As the backlog grows, claimants face multi-year
delays for hearings on their claims for benefits. The long wait for their day
in court often leads to homelessness, lack of medical care and the loss of
family and friends. And sadly, thousands die while waiting for a hearing.
The effects of the backlog
also extend throughout the agency. As SSA works to address the crisis, the
agency is forced to divert its limited resources away from its day-to-day
operations in Field Offices and Payment Processing Centers in order to try to
manage the disability backlog. SSA disability claims and hearings continue to
grow and hearing processing times are at record highs. If SSA does not
receive funding above the President’s Budget Request for FY 2009, the hearings
backlog will still be quite significant.
The 800 Number had a busy
rate of 7.5% in FY 2007 and handled about 59 million calls through agents and
automation. At the same time over 60 million phone calls are directed to SSA
Field Offices each year. In FY 2006, 51% of callers who tried to reach a Field
Office received a busy signal.
Staffing is at its lowest
level in 35 years: Staffing at SSA
will reach its lowest level since 1972, before SSI was established; yet, SSA
today has about twice the number of beneficiaries it had in 1972. Since the
beginning of Fiscal Year 2006, SSA Field Offices have lost nearly 1,800 Claims
Representatives and over 460 Service Representatives. The Teleservice Centers
have lost about 560 Teleservice Representatives. In Fiscal Year 2008 Field
Offices will not be able to adequately address staffing losses. The Disability
Determination Services (DDSs) have lost over 1,200 positions since the
beginning of Fiscal Year 2006, as a result their staffing levels are down
nearly 8%. The Program Center that handles disability actions (Office of
Disability Operations) has about 750,000 actions pending. This compares to
511,000 actions pending at the beginning of FY 2007. The average amount of
time it takes for a Benefit Authorizer to process a Post Eligibility case they
are assigned as of the end of February 2008 is 327 days. For Claims
Authorizers it is 378 days.
SSA’s workloads continue
to rise: Congress continues to add
to SSA’s workloads – for example, by assigning SSA responsibility for
administering portions of Medicare Parts B and D, and conducting Social
Security Number verifications and other immigration-related activities.
However, SSA’s administrative funding has not kept pace with the agency’s
increased responsibilities. 870,000 people on average visit SSA Field Offices
each week. Since the beginning of the year, SSA Field Offices have been
averaging about 950,000 visitors per week. In two separate weeks at the
beginning of Calendar Year 2008, SSA offices set all time record highs for
visitors. As of FY 2008 SSA has a backlog of 3,300 work years.
This is expected to grow to 8,100 work years in FY 2009. This backlog includes
hearing cases, overpayments and underpayments on cases, check problems,
earnings record corrections and recomputation of benefit, Medicare enrollment
actions and returning phone messages.
In Closing On Behalf Of The Social Security Disability
Coalition:
The Social Security
Disability program, which was originally set up to help us is currently failing
miserably at this task, and in fact, in many cases it is causing devastating,
irreversible harm to our health and financial wellbeing. We have contributed
our hard earned money to this system hoping we would never need it until we
were ready to retire. Where is the money going that has been mandatorily been
taken from our paychecks every week? Why should we have to become homeless,
bankrupt, starve, lose our healthcare coverage, suffer untold stress on top of
our illnesses and even die trying to get our benefits? Why should we have to
hire lawyers, wait years for hearings, go before administrative law judges and
be treated like criminals on trial? Why have you ignored this crisis for so
long, and done virtually nothing to reform it? We, the disabled citizens of
this nation, have been forced to tackle a very daunting system and we challenge
you to do the same, and correct these problems which have festered for decades.
We ask that you please start taking care of the US citizens living in this
country first before the rest of the world, especially the sick and the dying,
who trust you with their very lives and whom elected you into office. It is
your duty as elected officials to serve all those that voted you into that
office, and even those of us who didn't. When the next election comes around we
will not forget those who have forgotten us. We may be disabled but we still
have, and will use our right to vote. They
say you can judge a country by how it treats its most vulnerable citizens.
Based on current statistics, the USA should hang its head in shame! It is our
hope, and our right as American citizens, to expect that you will come together
as elected officials, and finally act swiftly to do what is proper to protect
and serve us.
I not only have complaints,
but also solutions, so I hope you will join me in my quest for total reform of
this program. Thank you for your time
and consideration.
Sincerely,
Linda Fullerton
President/Co-Founder – Social Security Disability Coalition
ssdcoalition@hotmail.com
585-225-3019/585-235-8412
PO Box 26378
Rochester NY 14626
Social Security Disability
Coalition – offering FREE information and support with a focus on SSDI reform:
http://groups.msn.com/SocialSecurityDisabilityCoalition
Sign the Social Security
Disability Reform Petition – read the horror stories from all over the nation:
http://www.petitiononline.com/SSDC/petition.html
Please check out my website
“A Bump On The Head” at:
http://www.frontiernet.net/~lindaf1/bump.html
Social Security Disability
Nightmare – It Could Happen To You!
http://www.frontiernet.net/~lindaf1/SOCIALSECURITYDISABILITYNIGHTMARE.html
CBS Evening News With Katie
Couric - Disabled And Waiting - 1/14/08
http://www.cbsnews.com/stories/2008/01/14/cbsnews_investigates/main3712627.shtml
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