I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on November 06, 2008, 07:20:40 PM
-
Problem Solver: Social Security Disability Backlog
By Dianne Derby
Anchor
Published: November 6, 2008
It’s a monstrous problem, one we hear about dozens of times each day here at News Channel 7. Viewers in our area filing for Social Security Disability insurance benefits and waiting years for answers. Sadly, some die before they even get a final answer from the government. So what’s being done to help and how is the backlog here, one of the worst in the country, getting reduced? Dianne Derby gets to the bottom of it in this 7 On Your Side Problem Solver.
“My life has changed dramatically since that one fateful day back in January of ‘06,” said Penny Knight.
That’s when Knight says she lost consciousness from a violent seizure.
“I know that my body is contorting and something is happening,” she said.
She says it’s all due a head injury she got during a car wreck more than 20 years ago. Knight says she used to stock shelves 6 days a week and was on her feet 10-12 hours each day. She says she can’t do that anymore because the of seizures and depression. In 2006, she applied for disability benefits with the Social Security Administration and was denied. She appealed and has been waiting two-and-a-half years for a hearing in front of a judge.
“It is a waiting game and a paper pushing game,” said Knight.
When 7 On Your Side got involved Knight got a hearing within weeks and a final answer a week later.
“It blows my mind what the media can do and how fast something can be resolved,” said Knight.
Knight’s attorney, Leah Broker, says applicants in the Upstate and parts of western North Carolina usually have to wait 3 to 6 months after the hearing for a decision.
“One thing the government doesn’t realize is they are putting people in poverty that otherwise wouldn’t be in poverty,” said Broker.
Talk about waiting. The SSA says the hearing office in Greenville is one of the most backlogged in the country. The latest stats they gave us show the average processing time for a case is more than 2 years. There are only four other offices in the country that have processing times worse than this one: Dayton, Indianapolis, Altanta North and Atlanta.
“These are citizens who’ve worked very hard, who have paid into the system, and you are taking advantage of them,” Broker said.
We went to the SSA’s regional headquarters in Atlanta to get answers from spokesperson Patti Patterson.
When we asked Patterson why 65% of cases are denied at initial level she replied, “Congress has imposed a very strict definition of disability for us. The definition of disability for our purposes is that your condition must be so severe that you are unable to work for at least a year or result in death.”
Some of those wait times are so long in 2007 the head of the SSA testified before Congress people have died before they get their day in court.
When asked what the SSA says to the families of people who do die waiting for a hearing, Patterson replied, “Well I want to extend my sympathy to those families for that loss. I want to say that we are working very hard we know that it is taking longer than it should.”
What is the SSA really doing to reduce Greenville’s backlog? They say this year they’ve hired 3 judges and 7 support staff. They’re also sending new cases to the Kingsport, Tennessee hearing office which is one of the fastest in the nation. They also are screening cases waiting for a hearing to try to make decisions without one. To learn more about what the SSA says they will do to reduce the backlog click here.
We wanted to talk with someone on a federal level that can really help. So we sat down with U.S. Representative Bob Inglis and asked him what could be done..
“If we fix healthcare and make it so that we figure out a way to effectively get everybody covered by some form of insurance there’s less of a there would be less of a line at the disability office,” said Inglis.
Inglis says in the next Congress he wants to be part of a health reform effort that does the following:
-Eliminates preexisting condition exclusions in individual policies
-Covers preventive and maintenance care
So how do applicants get what they deserve? Attorney Leah Broker says the bottom line is you must appeal and do it on time.
“At the hearing level we win, nationally, we win over 65% which tells you those earlier denials were not right,” she said.
Not right and not fair say people like Penny Knight who have waited years to get from the government what they put in.
“If you keep up the fight and you keep progressing forward there’s got to be daylight at the end of the tunnel,” said Knight.
If you have applied for disability benefits and have been denied make sure you appeal. Many people hire attorneys for help. They can’t charge a fee unless they win. Also contact your local Congressman to get your case the attention it needs. They have staff members who deal directly with social security disability claims. For a list of Congressmen in your area click here.
You can also read through the special LIVE CHAT with Amy Wood and our expert Leah Broker to learn more about how the system works.
Information below provided by the Social Security Administration.
About Social Security Disability Programs
Social Security Benefits
You may qualify for
• Disability benefits if you are a disabled worker and you have worked and earned enough credits to become “insured.”
• Survivor benefits if you are a disabled widow or widower, between 50 and 60 years of age, based on your deceased husband’s or wife’s work record.
• Child’s benefits if you are a disabled child over age 18, and either of your parents is receiving Social Security benefits or is deceased and paid enough into Social Security before his or her death to be “insured.”
Supplemental Security Income (SSI) Payments
SSI provides money for such basic needs as food, clothing, and shelter for people who are blind or disabled. To get SSI you must have little or no income or assets.
Medicare
Social Security has a special program for people of all ages who have kidney problems requiring dialysis or a kidney transplant. Medicare coverage is also available to people who have been entitled to Social Security disability benefits for 24 months and to government employees who meet Social Security’s definition of disability and are “insured.”
Medicaid
Medicaid is a jointly-funded, Federal-State health insurance program for certain low-income and needy people. Eligibility requirements vary for each State. Medicaid is administered by the Centers for Medicare and Medicaid Services under the Department of Health and Human Services.
More Information
• Call our toll-free number, 1-800-772-1213. If you are deaf or hard of hearing, call the toll-free “TTY” number, 1-800-325-0778. Representatives are available Monday through Friday from 7 a.m. to 7p.m.
• Visit your local Social Security Office.
Appeal A Decision
If your disability application is denied, the letter we send you explains the reason for the denial and how to request a review of our decision. Depending on the reason, you may be able to request your appeal online.
If your application is denied for
• Medical reasons, you can complete and submit the required Appeal Request and Appeal Disability Report online. To appeal a decision online click here.
The disability report asks you for updated information about your medical condition and any treatment, tests or doctor visits since we made our decision.
• Non-medical reasons, you should contact your local Social Security Office to request the review. You also may call toll-free , 1-800-772-1213, to request an appeal. People who are deaf or hard of hearing can call the toll-free TTY number, 1-800-325-0778.
To find a Social Security office click here
Find a Disability Lawyer
This information is from the South Carolina Bar Association Web site.
What is the Lawyer Referral Service?
The Lawyer Referral Service is a public service of the South Carolina Bar. The service is offered by telephone and online. The telephone service operates from 8 a.m. to 6 p.m. Monday through Thursday. The telephone service is closed on Friday. To reach the telephone service, call (800) 868-2284 (in Richland and Lexington counties, dial 799-7100). The online service is available 24/7.
How does it work?
The services offers a referral to a person by the area or location needed and by the type of law.
What is expected of me?
When you contact the service by phone or access it online, you are expected to provide the name of the potential client, the address and the city, state and zip. You will also be asked how you found out about the Lawyer Referral Service.
If you contact the service by phone, you will be asked to provide a brief explanation of your possible legal situation. You will also be asked the county in which you are seeking a lawyer. If you access the program online, you will select the county and the type of law, and you will then need to type a brief explanation of your legal situation.
Whether you use our service by phone or online, you will be given the name and number of one attorney to contact that fits your situation. If the lawyer is unable to assist you, please call the Lawyer Referral Service and explain the situation to the operator, and he or she will try to assist you with another referral.
Once you receive a referral, you will be expected to contact the lawyer by telephone to make an appointment.
What other options are available?
If you are indigent and unable to pay for a lawyer’s service, you may want to contact LATIS at 1-888-346-5592 to see if you qualify for free or reduced fee legal services. This program will screen you to see if you qualify. If you do not qualify, they will refer you back to our service. To find out more about LATIS, you can visit http://www.sccej.org.
Contact Social Security
The following information was obtained on the Social Security Web site.
By calling 1-800-772-1213, you can use automated telephone services to get recorded information and conduct some business 24 hours a day.
If you cannot handle your business through our automated services, you can speak to a Social Security representative between 7 a.m. and 7 p.m. Monday through Friday.
If you are deaf or hard of hearing, call our toll-free TTY number, 1-800-325-0778, between 7 a.m. and 7 p.m. Monday through Friday.
If you still need additional help, you may write to the Office of Public Inquiries:
Social Security Administration
Office of Public Inquiries
Windsor Park Building
6401 Security Blvd.
Baltimore, MD 21235
Or you can contact your local office.
More on the process
Described below is what happens when you request a review of the determination made on your disability case:
• You send a signed request for appeal to Social Security.
• They review it to make sure all of the information is complete. They may contact you for missing or unclear information.
• They will contact you to complete a disability report and to sign medical release forms if you have not already done so. If you have submitted the report They will review it to make sure all of the information is complete.
• They will send your case to the office that determines if you are disabled under Social Security law.
• That office will request any new medical records that you have listed on your medical report.
• That office will then review all of your medical records—both old and new.
• If you have requested a face-to-face review, that office will make an appointment to meet with you. You will have an opportunity to meet face-to-face with someone from the office that decides your case. If you want this face-to-face meeting, they will make the appointment with you.
• The decision-making office will notify you in writing of their decision on your case.
There are four possible steps in the disability appeals process. They must be completed in the order listed below if you disagree with the determination on your case.
Type of Appeal Appeal Process
Reconsideration You should complete a Request for Reconsideration and an Appeal Disability Report. Both forms can be completed on the Internet, and submitted electronically to Social Security, or you can complete paper versions and send them to your local Social Security office. No matter how you complete the forms, Social Security will send your case to the State Disability Determination Services office. Someone there will review your medical records and make a new determination about your disability. It will not be the person whom made the last determination on your case. After reviewing your medical records, they will notify you in writing of their decision.
Hearing You should complete a Request for Hearing by Administrative Law Judge and an Appeal Disability Report. Both forms can be completed on the Internet, and submitted electronically to Social Security, or you can complete paper versions and send them to your local Social Security office. No matter how you complete the forms, Social Security will send your request to the Office of Disability Adjudication and Review. If you want to meet face-to-face with the judge, an appointment will be made for you. After talking with you and your representative, the judge will notify you in writing of his/her decision on your case.
Appeals Council Review You should complete a Request for Review of Decision/Order of Administrative Law Judge Link. You cannot do this on the Internet. Sign and send it to your local Social Security office. They will send your request to the Office of Disability Adjudication and Review. Someone there will review your medical records and notify you in writing of the decision on your case.
District Court Case You must have an attorney at this level of appeal. He or she must file a case against Social Security in District Court. Your case will be heard by a district court judge who will notify you in writing of the decision on your case.
Your right to representation
You can handle your own Social Security appeal with free help from Social Security, or you can choose a lawyer, a friend or someone else to help you. Someone you appoint to help you is called your “representative”. You cannot choose someone who has been suspended or disqualified from representing others before the Social Security Administration or who may not, by law, act as a representative. You may contact your local Social Security office for a list of legal referral and service organizations. Social Security will work with your representative, just as we would work with you.
If you want to appoint someone as your representative, you or your representative must first complete SSA-1696 (Appointment of Representative) or send a written statement naming your representative. If your representative is not an attorney, he or she must sign the statement or SSA-1696 or state in writing that he or she accepts the appointment, before you send it to us.
Your representative cannot charge or collect a fee from you without first getting written approval from Social Security. However, your representative may accept money from you in advance as long as it is held in a trust or escrow account.
Both you and your representative are responsible for providing us with accurate information. It is illegal to furnish false information knowingly and willfully. If you do, you may face criminal prosecution.
Questions?
Call toll-free, 1-800-772-1213. If you are deaf or hard of hearing, call our toll-free “TTY” number, 1-800-325-0778. Representatives are available Monday through Friday from 7 AM to 7 PM.
The Social Security Online Internet Security Policy
Is it safe to apply for Social Security benefits over the Internet?
SSA is taking all reasonable and proper measures, including encryption, to ensure that your personal information is disclosed only to you. However, the Internet is an open system and there is no absolute guarantee that others will not intercept the personal information you have entered or requested and decrypted. Although this possibility is remote, it does exist.
What is encryption?
Encryption means that all information relating to you and your account is scrambled and locked with a mathematical key during the electronic transfer. Most browsers have an icon such as a key or a lock to represent an encrypted mode or session. A broken key, open lock, or no lock indicates that the session or mode is not encrypted.
Why is special software necessary to access the Internet application?
So that your online request can remain confidential, SSA uses a security protocol (method) called Secure Sockets Layer (SSL) for this application. You must use a Web browser that supports SSL. Netscape Navigator and Microsoft Internet Explorer are two browsers that support SSL. Using this security protocol, all information sent between your computer and our server is encrypted before being sent on the Internet.
Why SSL?
SSL provides a high level of security and is the security protocol supported by more browsers than any other. It is estimated that about 92% of Web browsers have an SSL browser available for their use.
I have the right software and I am trying to connect during your posted business hours, but I still cannot access your form. Why?
We have found that a number of business, government, and educational networks do not have their firewalls configured to allow passage of secure Web traffic. Check with your systems administrator to determine if this is the case at your site. If this is the case you will not be able to access this application web site.
http://www.wspa.com/spa/news/problem_solver/article/problem_solver_social_security_disability_backlog/10758/
-
Great resource information.
-
I know that this topics is years old, but even though it has been 4 years since you posted this, the backlog has only gotten worse. Here is an article from July, 2011: http://www.socialsecuritydisability.tv/blog/social-security-disability-backlog-grows (http://www.socialsecuritydisability.tv/blog/social-security-disability-backlog-grows). This article says that the average wait time to have a hearing scheduled is about 369 days, which is well below the goal of 270 days set by the SSA.
-
I can only say from working in a field office that this is due to Congress and their hiring freeze and budget issues We cannot replace employees that retire, promote up, quit or otherwise. I've been in my current office 3 years. In that time we have lost 12 people and gained 6 - only 2 were new hires, the rest were transferred into the office or promoted into vacant positions, meaning 4 other offices lost people. I know our local hearings office just had a judge retire, who cannot be replaced. There is also no OT to work on the cases that we do have. And believe me, we all feel terrible about the length of time it takes for some claims to be approved (or at least I do) but we can only do so much with the very little we have. I know they have already told us that they expect the backlogs to get worse in the upcoming year unless a budget gets passed that allows us to hire again.
Oh, I also haven't received a raise in 2 years thanks to the same people that make the sick wait for benefits, because you know, my salary is what caused this financial mess. So we all suffer :(