From KUSA in Denver:
Americans with legitimate disability claims are routinely denied benefits under the Social Security Disability Insurance program, then find themselves trapped waiting months, even years, to get a decision on an appeal ...
[W]hile more than 1 million people wait for their appeals to be heard nationwide, many lose their savings or retirement funds, others their homes, sometimes ending up on the streets.
Thousands have died while waiting for a hearing, according to the Office of the Inspector General.
“It’s this major injustice,” said Denver disability attorney, Will Viner. “What has happened with the increase in the backlog is people are losing their house, unable to pay for food and shelter. In the past year we have had nine clients pass away.”...
And the delays are getting worse.
In Denver for example, the average wait time to come before a judge was 18 months in January 2018. In the same month of 2014, the wait was 11.5 months. ...I love the graphic that someone did for KUSA. Good work.
28 comments:
Waiting on ssi or diability is just like death row slowly killing people who are really sick and needing medical ,financial, etc ,help especially hard working people who have worked hard and already paid into the system, this so unfair.....
10:54, fair is a place where they judge pigs. The backlog is the product of many things, but mostly underfunding the agency. Instead of wasting time wringing your hands and whining on blogs you should be forwarding these articles every single day to every one of your Representatives and Senators.
I think the entire blame for this rests totally and completely on the shoulders of the public that have not made this a priority in DC. You can blame them all you want, but I would bet my bottom dollar if every single person waiting on a Hearing wrote a letter (you remember those, pen, paper, sentences without emojis) to their Senators and Representatives this would be addressed in a matter of months.
Quit waiting for "somebody" to do "something" and do it yourself.
Let's be frank...the news stories about long waits for a disability decision are sensationalist but misleading. In actuality, most claimants already received two decisions based on their medical records. They may want a third bite at the proverbial apple, but they had a chance to present their records, oftentimes attend a consultative examination, and have a doctor review their claim.
While I am in favor of shorter wait times for ALJ hearings, these wait times often play in favor of claimants who have a chance to receive further treatment that may help their claim on appeal. I see a lot of cases where claimants have few medical records, or unclear diagnoses, prior to the DDS decisions, only to see additional providers in the year leading up to the hearing that document a progressive ailment. I also see people whose condition improves after receiving treatment, who go back to work pending appeal, or who stop seeing providers altogether.
Yes, DDS gets it wrong from time-to-time, but if representatives really wanted shorter wait times, they should perhaps find a way to limit the extent to which high-volume firms flood the system with anyone and everyone that would sign a fee agreement. I'm sure none of the honorable representatives on this board work for such firms, but my office receives more than 50% of its appeals from high-volume firms. Hearings are held daily with claimants who returned to SGA work within 12 months of losing a job, who have expired DLIs with no medical records even close to the DLI date, whose own doctors state they can return to work, who abuse drugs and treat emergency rooms as opiate dispensaries, and who aspire to nothing more than playing video games in their parents' basements all day long. And dare I say some representatives make a habit of withholding medical records until a few days before the hearing when they would have been useful at the DDS level or for an on-the-record decisions -- either because they're inept, or to increase their fees, or both.
Yes, SSA could hire more ALJs and support staff, though you can only do so much hiring in the current political climate. But it strikes a disingenuous chord when representatives complain about long hearing wait times but then turn a blind eye to the substantial part their brethren play in creating the backlog.
It's the attorney-represented cases that spend the most time in POST. It's not uncommon to see three to four postponement requests by attorneys for each week of hearings per individual ALJ, because the record isn't complete yet. Too many attorneys treat the record as something that magically happens without their active engagement....
12:16 PM. Wow. Your "experience" is so vastly different from my reality as a claimant. It's like from a completely different planet, to paraphrase Obama. I see an organization that systematically cherry-picks statements, often ignoring the context; dismisses evidence that verifies the claimants statements... I see a culture of deny, deny, deny that doesn't care if the claimants can actually work. Your statement reinforces that perception, while also demonstrating the contempt you have for claimants. Can someone with your attitude be "fair" to a claimant? If you were a potential jurist, you would be among the first to be challenged for cause.
Tim: As an individual claimant, you profess to know an awful lot about the Social Security Administration and it's thousands of employees, who are all apparently out to get you. You also seem to know a lot about the plight of other claimants, so I assume your friends and neighbors have shared their stories with you...and their medical records. I applaud you on your initiative to gather so much information and share your conclusions with simpletons like me on this forum.
I, on the other hand, have only conducted thousands of hearings and read at this point millions of pages of medical records. I have worked with representatives in three states and have seen the good, the bad and the ugly. What you unfortunately see as a culture of "deny, deny, deny," I see as individuals trying the best they can to help people that have fallen on hard times. But hard times are not always equivalent to inability to work. What you seem to infer as "contempt" for claimants, is instead the gospel truth about a very complicated disability system and an even more complicated social safety net and economic system that has left too many people behind. So to answer your question, I can be "fair" to a claimant, and up until now no one has accused me otherwise. I hope you can one day be "fair" to the men and women of the Social Security Administration.
at 2:11PM - since attorneys are delaying the process sooooo much by not getting records, why don't we try this - even in atty-represented cases, require the ALJ to request, follow-up, obtain, sort through and submit all the medical. Remember, it has to be done within 5 business days of the hearing though. SSA only has to pay a flat fee of $14 or so for these records anyway. it's a WIN-WIN for everyone, right? ALJs are happy because we've solved that pesky "lazy attorney getting records" problem. Clients are happy because their medical records costs have been eliminated. And now you won't have any decisions waiting in POST! Weeeeeeeee!
7:22 - While I know you're being facetious, that is actually a good solution. But be careful what you ask for -- in your situation, why would the rep be entitled to collect fees? I don't want to turn this into a rep vs. SSA discussion, but believe it or not, there are reps that are so bad that OHO has no choice but to order records in order to conduct the hearing and close the case in a timely manner. I'm not saying all representatives are lazy, but if we're being totally honest, you and I both know that there are plenty of lazy reps to go around. And to paraphrase the expression, the bad bunch spoils the good apple.
@4:07 Bravo!
Wow, it’s all the representatives fault and if we write to our congressmen folks like Paul Ryan will say oh, a problem with SSA? We will get right on it after we destroy Medicaid and reduce Medicare to pay for the billions in tax breaks for the rich. In 15 years of national practice, I have seen maybe 2 cases where ODAR requests records. If representatives didn’t do this for the agency, virtually no update would be available at hearings. And as far as all the claimant’s playing video games high on opioid’s, at least 40 percent of claimants are allowed at the Hearing level. If the DDS got it right the first time, and if ALJs would allow more OTR requests, this wouldn’t happen. Yes, the agency is underfunded. Republicans have systematically caused this. No 50% of claimant representatives are not responsible for years delay, nor are claimants.
9:57 - The amount of hyperbole in your statements is astounding. First, no one said it was "all the representatives fault." There are many factors leading to delays in adjudicating the backlog. However, anyone familiar with the process would acknowledge that high-volume law firms flooding the system with claims while putting in the bare minimum of work in screening their clients surely contributes to wait times.
In 15 years you have seen maybe 2 cases where ODAR requests records? Surely being an experienced practitioner, you realize that ODAR (now OHO by the way) orders records for all unrepresented claimants? Further, as someone involved in a "national practice," you must be familiar with SSR 17-4p that outlines OHO's duty to assist in developing records. My associates and I routinely order and subpoena records for representatives that are unable to obtain or afford the records. The most important factor in evaluating a claim and conducting a hearing is having all the records in advance of the hearing. It's shocking how often some representatives fail in this.
No one said "all claimant's playing video games high on opioids." Those factors were mentioned in the context of how some high-volume firms do not screen their clients and consequently schedule hearings on cases that have no chance of success on the merits. Taking statements out of context is a sign of poor lawyer skills. But I don't need to point that out to someone with 15 years of national practice.
No one said "50% of claimant representatives are responsible for years of delay." You may be referring to the statement above that 50% of a certain office's appeals stem from high-volume firms. I'm not sure why you'd conflate that statement to mean that half of all representatives are causing delays. Unless you wanted to create a straw man argument for your fake outrage. Congratulations, you succeeded.
Your solution seems to be that DDS pay more cases and that ALJs grant the rest without a hearing (OTR). With a fool-proof plan like that, you should apply for the Commissioner's job.
So one of my clients was denied by the ALJ after waiting for 3 years. I read the entire letter and it was obvious the judge had no idea what her condition was (guillen barre syndrome. His decision even discredited physical ailments based on a mental exam she had with a therapist.
He also dismissed a diagnosis as he couldn't establish an onset date.
Do these ALJ's have any medical training whatsoever? How are they dismissing medical source statements from experts when they don't even know the specifics of a particular disease.
The whole thing is very troubling. Not sure if I tell my client to appeal again or start over.
"If representatives didn’t do this for the agency, virtually no update would be available at hearings."
My gosh, reading this one would scarcely know we're talking about a claim a person voluntarily filed, has the burden to prove, and has a representative--oftentimes a lawyer--to assist with. Is there no responsibility of the claimant--and I'll restrict this to only attorney-reppped claimants--to get their own evidence and make their own case? Sheesh!
Not to stick up for the "high volume national firms," but they are often forced to accept all clients that are sent to them from the long term disability carriers or insurance companies, if even they appear to lack merit. As someone who used to handle some of this work, if you turn away a bad case, the insurance company will just look for another firm to handle all the work. Because their contract forces the individual to file for SSD because of the coordination, you will file all the cases to keep the referral source happy. You can't pick and choose. And if it's a marginal case that you will know will lose and won't see a fee, you are not as motivated to spend your money out of pocket to order all the updated medical records. I'm not condoning the practice (we never operated that way), just explaining the reality. If you blame high volume firms for bringing non-disabled cases and clogging the system, the blame, at least partly, instead lies with the insurance companies forcing their recipients to file in the first place.
@12:41:
Let me get this straight: On one hand you guys want claimants and their reps to take more responsibility. After all, they have the burden of proof.
On the other hand, claimants like Tim above, whom many of you have criticized, and not long ago wondered whether he was an insider before realizing he is a claimant, has clearly taken responsibility and a very active interest in his case, as revealed in the frequent comments he has made on this board the last 2 years.
As a longtime insider, Tim has taken more responsibility and sought to learn SSDI laws and Regs, more than many well educated claimants cases I see. Give credit where credit is due. While Tim has been critical of SSA Disability, he has not entirely been off base. I have witnessed an increased culture of denial since the Tea Party Republicans began taking over Congress several years ago. I have also overheard ALJ’s and others talk in negative generalities about claimants as whole. I can’t tell you how many times I have overheard talk with laughter among ALJ’s like, “Well, the longer we deny, the more likely it is they will get tired, get a job, and go back to work.”
Even though Tim’s focus may be through the small prism of what he has personally experienced and read on this blog, he is not completely wrong in some of his assertions. Not every ALJ engages in such conduct, but many do. Just saying . . .
@3:23-
I won't condone the type of statements you've overheard, even if they may be a form of gallows humor. That being said, it's a far stretch to link that to some sort of Republican conspiracy. No question that the current batch of Republicans seem bent on eliminating every vestige of the government safety net. However, ALJs are pretty well insulated from political pressure, for the time being. I have not experienced or heard of any pressure to decide cases any particular way, unless perhaps an ALJ has a 99% grant or denial rate. Even then, management tiptoes around the judicial independence issue.
What I have heard from several judges that have held the job lengthy periods of time is that the type of cases they see has changed over time. I've heard it said that cases were more clear cut before, and the disabilities easier to analyze with assurance. Another person stated that he was able to help more people before, but now those cases are far and fewer between. The NPR article from a few years ago dances around these issues. Fifty years ago, most people that received disability had diagnoses based on objective test results such as heart disease, stroke, neurological disorders. Now, the majority of disability applicants claim back pain and mental health problems. Even in the case of back pain, these are much more subjective impairments.
The trend seems to be a gradual increase in denied claims, but I have not witnessed a "culture of denial." There are no emails from the commissioner stating that the grant rate is too high. There are no secret meetings conniving new ways to deny claims. Heck, ALJs typically don't even converse with ALJs in different offices. Even the refresher training is now virtual. Yet the trend is the same nation-wide. Blame it on some change in the impairments alleged, on baby boomers aging, on a change in the economy, on jobs being offshored, on greater access to representatives and the advertising of their services, on greater access to healthcare, or on a million and one other reasons. But behind the curtain there is no conspiracy. Just a bunch of people trying to figure out what the doctors are saying. The same doctors that themselves seem bewildered half the time.
12:16 PM. Some of these articles by the Washington Post seem to choose to highlight claimants in order to paint a picture: that claimants are a bunch of illiterate, lazy, drug seeking, rednecks coming from poor, jobless, rural counties. The roofer from Alabama (Disabled or Desperate) is one where it is easy to see he has virtually no chance of being approved. Even if he was 50 or 55... Very doubtful. However, I think this is a deliberate attempt by the Washington Post to suggest these people are typical of those denied by SSA. Therefore, some of these other stories may be a pushback to the Post. One "advantage" I have had in basically 4 years of not being able to work is that I have time to read. I have read hundreds or thousands of comments from people who have been denied by ALJs. After awhile, you start to see common themes. The ALJ claimed the claimant "wasn't credible" because he found a statement "the patient was able to move... ". In my decision, the ALJ cited one particular statement like this. At the SAME APPOINTMENT, the doctor ordered an MRI "due to bilateral shoulder pain" AND referred me to an Orthopedic Surgeon for my shoulders and a second one for my hands. The appointment was 2 1/2 months into a six month period where I was on "Accident and Sickness" from my company. I missed 9 months for the same reasons the previous year. After the six months, I returned for a greatly reduced role than I had had two years earlier for about 4 months ( with 2+ weeks off during Christmas). Like an experienced MLB hitter that you keep around because he's always given you whatever he had, knows what to do when... But, you both know the end is near. Then, you both realize that you just can't even handle the greatly reduced role... Not even with frequent holidays, extra days off, longer breaks... I went on A&S for 3 weeks and returned for 2 5-day stints two weeks apart. In those last few weeks, the ALJ cited "Returned without restrictions" in his decision.
When I read others statements on those websites, I see other ALJ "leaps of faith" based upon a statement or two that ignores the context. I have read statements from Federal Judges who criticise SSA for doing this repeatedly, along with using "boilerplate statements" in their decisions and also claiming "the claimant wasn't entirety credible" or "lacks credibility" without cause. If even one-tenth of these people's claims are true, that is way too many.
For every wrong denial I can find a matching person in pay that is not disabled.
9:35 AM. Just a "zero sum" game to you? Would your attitude be the same in criminal law? Half a million innocent people sent to prison... That's alright. There's probably half a million criminals walking in the streets. So, YOU don't care about the truth!
@10:14-
You hit the nail on the head with this comment. No system is perfect. Sometimes innocent people go to jail, sometimes criminals go free. And that's a system with police and witnesses and lawyers and prosecutors and judges and juries. Yet you seem to expect SSA to get it right 100% of the time? We're human, and the unfortunate consequence is that we make mistakes, whether you're an ALJ, a doctor, or a plumber.
I hope the two DDS doctors, the CE you saw, and the ALJ in your case got it right, and your condition is either improving or you can find a job despite the shoulder and hand pain. You seem quite capable of reading "hundreds of thousands of comments" and typing, so perhaps you can find a clerical job. If they got it wrong, then that is unfortunate. But you can file again or appeal the decision all the way to the Supreme Court if you so wish. Which is more options than the guy wrongly convicted in prison.
18 months in January 2018. In the same month of 2014, the wait was 11.5 months. ...
That is evidence of which political party has concern for the sick and other unfortunate individuals.
10:40 AM I read them 10-15 a day. I "type" for a couple of minutes using a finger or two. I put the tablet down for a few minutes. I try to finish my thought... I should point out that I have Ankylosing Spondylitis, Fibromyalgia, Sleep Apnea, Osteoarthritis, Dry Eye Syndrome (causes frequent migraines), IBS, Hemifacial Spasms, etc. I also used to have epileptic seizures (grand mal, petite mal and pychomotor). I have had a few concussions and partial shoulder separations from falling during a seizure, including both when I broke my jaw. I also dislocated my hip when I fell from a high second story window when I was 5. The window (frame and all) fell out when I sat on the ledge (it was several inches wide, like a seat sticking into the room.
I really hope you're a troll. If you're an ALJ...
Tim... I am not a representative of SSA just a claimant myself but i feel someone should apologize for that statement so 'I am sorry' i know it means nothing coming from me but it's a cruel world and sometimes people just need to be empathetic even if that's all we have. There is a site where all of us claimants get together and talk and help eachother ssdfacts.com if your not a member already a lot of us could use your "experience" and insight.
"It is better that ten guilty persons escape than that one innocent suffer"
-William Blackstone
Now i don't agree that 10 guilty should go free but it has a good meaning. Lot's are left to suffer because of a few bad eggs. NO one expects SSA to get it right all of the time but i think the system needs fixed. I think we need to have compassionate judges... I hear of people being belittled and treated like crap from ALJs most of which are the "outlier deniers" with less than 25% approvals but that should never happen... Its bad enough our fate is being judged by a 30 minute hearing by someone who can't "walk in our shoes" and most of time has no medical or psychology degree but to be belittled is uncalled for. I can't say i had the same belittling experience, thank God I don't think i could have handled that. My judge was respectful and had good court mannerisms but I am still waiting on my decision from my hearing in September unfortunately... Fingers crossed though that he saw what was going on in my body and mind. But back to my point the outlier judges whether approvers or deniers should all be being investigated not just the one that approve. You look at some of these stats 10% 12% 19% approvals that is almost impossible that the other 80-90% were not disabled. Who would live like this for years without any income unless they couldn't work?!?!
There sure is a culture among many ALJs, especially newer ones, and it has way more to do with how OPM grades and selects ALJ candidates and the fact that so many of the higher scorers are prosecutors than any pressure from the top to deny.
You think it's a good idea to pick people who were super adversarial most (all?) of their careers in real litigation settings to be the fact-finder, nonadversarial decision maker SSA needs them to be in our informal hearings? Just think about some of the systemic problems affecting criminal justice--racism, classism, etc.--and imagine how folks spending their formative legal practice years as the arm of the state doling out this perverse justice might take some of those bad habits with them in SSA hearing rooms, especially considering the demographics of our claimants. But I digress.
You want more pro-claimant ALJs? Work to get OPM to quit essentially forcing SSA to hire so many former prosecutors, duh!
@5:22
3:23, Feb. 22 here: You hit a grand slam and knocked the ball out of the ballpark!
BRAVO!
I don't see anything wrong with the ALJs, other than they could do a little more and be a little clearer. If former prosecutors are what we are seeing, bring them on!!!
@4:55 - My experience has NOT been that SSA is hiring so many former prosecutors. I'd like to know where the statistics come from for this statement. The last class of ALJ's I saw (last year) were a broad group of intelligent individuals from a very diverse background to include SSA insiders, government insiders, and outsiders.
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