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Benefits in Doubt

by Eric Herr
As the Social Security Administration struggles with a backlog of disability applications, hundreds of people across South Jersey are falling through the cracks.

In 2004, Stephen Morace, a Mount Laurel resident and longtime security systems customer service representative, was on his way home from his job when a devastating bus crash unexpectedly plucked him from the workforce. Morace, in his late 50s, found himself with no use of his left hand, with herniated disks that caused excruciating back and neck pain, and with additional medical complications that prevented him from returning to his job.

For individuals like Morace, two government-funded benefit programs—Social Security Disability Insurance (SSD) and Supplemental Security Income (SSI)—are meant to help. But it took Morace from 2007, when he first applied, until June of this year to obtain any benefits at all.

Across New Jersey, thousands of people like Morace have been waiting for months or even years to collect benefits while suffering from injuries or illnesses such as cancer, AIDS or mental health conditions. For some, benefits may mean the difference between being able to stay in their homes and remain independent, or being at risk for homelessness and other concerns. And as the economy lags, the problem is only getting worse.

Only 35.8 percent of applicants were awarded disability payments and 55.9 percent were given medical allowances in 2008—a marked decline from a decade earlier, when more than half of disability applications were approved. As well, the total number of claims has more than doubled in the past decade. Now, some 728,000 people nationwide are waiting for appeals for denied disability payments to be heard, a 5 percent increase over the last year, according to a recent report from the Transactional Records Access Clearinghouse out of Syracuse University. And New Jersey is the 13th worst state in the nation for processing lag, according to an analysis of Social Security Administration (SSA) data by Allsup: the average appeal time in the state is 487 days.

“Applicants may be waiting as many as two to three years to get the benefits they deserve. In many instances, hearing offices are having trouble keeping up with the high demands of requests, resulting in longer wait times,” says Eric Shore, a lawyer whose Cherry Hill practice specializes in SSD and SSI appeals.

Experts see the graying of the U.S. population, coupled with a bad economy, as significant factors in the growing number of claims. “There’s no doubt that, as the baby boomers age, the diseases of aging and related infirmities kick in, thus increasing the disability benefit roles,” says John D. Worrall, a professor of economics at Rutgers University-Camden.

But the problem isn’t just volume—it’s also deciding who gets benefits, and who doesn’t.

Both SSD and SSI benefit programs factor in variables like age, education and work history when determining eligibility. There are clear distinctions between the two programs, however. “With SSD, part of every paycheck you earn goes into the Social Security system, one portion going toward retirement, the other toward disability, which you can collect, if needed, before retirement,” Shore notes. Unlike SSD, SSI applies to those who have never worked, have no financial savings, or have a disability that prevents them from working for at least a year or that could be fatal.

“[Benefit] eligibility has been a contentious issue for years. While the Social Security Administration has tried to have the rules applied uniformly across regions, they haven’t always had great success,” Worrall says.

And those who run up against the system say it’s not always easy.

Clementon resident Susan Schaeffer, who was previously a medical bills collector, applied for SSD after being diagnosed with chronic gastroperesis and spastic colitis in 2006. Schaeffer, 27, initially decided to tackle the application process on her own—but after twice being denied, she opted for legal representation.

“I was being denied because of my age,” explains Schaeffer. “My education level included some college, and they said I could work—[the same type of] job I did when I was 16.” She explains that the initial ruling failed to take into account her daily bouts with abdominal pain, diarrhea or constipation, acid reflux, fatigue and other mitigating factors that would have prevented her from working under any circumstances.

Then, there’s Morace, who was denied twice during the SSD hearing process.

“There’s so much paperwork to get together, not to mention sending all the information to multiple agencies, and spending countless frustrating hours on follow-up phone calls,” says Morace. “You can’t be sick and do all this, trust me.” Morace’s case was eventually cleared, after his third appeal—this time, with the aid of legal counsel.

There has been some improvement recently, particularly via a new electronic application format. The SSA has also reportedly hired upwards of 375 administrative law judges, plus nearly 1,000 support staff over the last two years. Moreover, they have added four National Hearing Centers to help process hearings by videoconference from the hardest-hit areas of the country. And, there are plans to open 14 new hearing offices and three satellite offices. As a result, the time it takes to make a decision has been cut by nearly two and a half months since December 2008, the SSA reports.

But while the SSA is making some strides, the most important advances may come from claimant advocates, notes attorney Robert Petruzzelli of Cherry Hill’s Jacobs, Schwalbe & Petruzzelli. He’s a member of the National Organization of Social Security Claimants’ Representatives. “The online application process has definitely been a plus,” says Petruzzelli, a former SSA employee. “But being able to share information with [National Organization of Social Security Claimants’ Representatives] attorneys anywhere in the country about similar cases, and how they navigated through the judicial process, helps all of us to better assist our clients in getting the money they deserve more quickly.” Even so, cases often take anywhere from six months to several years to resolve, depending on a number of different variables—one of which is often whether the applicant seeks representation.

“Many people do try to navigate through this complex process on their own. But there are often many details and subtle legal distinctions regarding a disabilities case that judges look for, but may not always be immediately apparent to the lay person,” says attorney Dan Harrison, from the Law Offices of Eric Shore.

Harrison took on Schaeffer’s appeal, helping her tell her story—and describe her daily agony—via teleconference to a judge. The judge finally ruled in her favor, making her benefit payments retroactive to July 2007.

But even for those who do clear the hurdles of the benefit application and approval process, there are lingering questions regarding the long-term viability of the SSD and SSI programs.

According to the Congressional Budget Office, the number of people receiving disability benefits nearly tripled between 1970 and 2009, from fewer than three million to nearly 10 million. By 2015, the number of people receiving disability benefits is projected to be close to 12 million, with total expenditures skyrocketing above $150 billion. At that rate, the Disability Insurance Trust Fund may be exhausted by 2018.

Despite these foreboding statistics, some experts are still optimistic.

“I’m not sure I would characterize the current situation as a crisis,” says attorney Alan Polonsky, who was with the SSA prior to opening a private law practice in Audubon.

“It is definitely a problem, and there may need to be some adjustments in terms of fund transfers between the retirement and disability trust funds. But the government has done it before and they can do it again.”

Published (and copyrighted) in South Jersey Magazine, Volume 8, Issue 5 (August, 2011).
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