If you plan to apply for Social Security Disability (SSD) benefits, the two things you’ll need are patience and perseverance. Why? It generally takes between three and five months for the Social Security Administration (SSA) to make an initial decision based on your application. If your disability claim is denied, you will enter the reconsideration stage, which lasted an average of 103 days in 2018.
Individuals who are denied disability benefits at this stage then wait for a hearing with an Administrative Law Judge (ALJ). In Buffalo, the average number of days between a hearing request and final disposition was 545 days in October 2019. In Rochester, the wait time is 595 days. These hearing wait times put Western New York’s hearing offices at 152nd and 160th (of 165 hearing offices), respectively.
How long does it take to get Disability? Western New Yorkers who go through all three stages of the SSD application process can wait as long as five years. During this time, claimants cannot earn an income, and their condition continues to worsen.
Even the judges responsible for SSD decisions call the system in which they work one in the midst of a “crisis.” According to these judges, the long wait for hearings is only one of several serious problems that affect a system on which millions of Americans depend. “People deserve the right to have their cases heard within a reasonable amount of time. The current waiting time is not acceptable,” said Marilyn Zahm, an ALJ in the Buffalo district.
Why Does a SSD Decision Take So Long?
Funding gaps, staff shortages, and a growing number of SSD applications plague the SSA. These factors resulted in a backlog of approximately 720,000 individuals as of March 2019.
An audit by the Social Security inspector general uncovered low morale, insufficient staff, and too many SSA employees working from home in New York’s SSA offices in 2018. The number of SSA employees who work from home has increased exponentially. The number rose from 2,600 employees in 2015 to over 5,500 in 2017.
The SSA stated that the wait time for an SSD decision is getting longer because an aging baby boomer generation is putting additional strain on the system. In a 2008 CBS News interview with Michael Astrue, former SSA commissioner, he noted that as our population ages, the number of claims for SSD increases. The situation only worsens as baby boomers grow older.
In 2020, the SSA will continue to address these issues with a budget of $12.773 billion. The Plan for Compassionate And REsponsive Service (CARES) outlines the path to a reduced hearing wait time of 270 days. The SSA is working to reduce the backlog with 600 new ALJs and over 650 support staff. Even with these measures, the SSA reports that the backlog is likely to persist until 2021.
Dying for an Appeal
During 2016 and 2017, the number of people who died while waiting to learn if they qualified for SSD benefits increased to 18,701. This unfortunate reality is the outcome of increasingly long wait times before claimants find out if they are will receive benefits.
“I once received a letter from a family member of a man who waited for a long time for his case to be heard, and before it could be heard, the man died,” said Randy Frye, an ALJ from Charlotte, N.C. “It made me feel terrible… That just shouldn’t happen.”
CBS News found a “culture to deny” among the examiners who review applications. Claimants suffering from strokes, heart attacks, and even brain cancer were denied benefits. One former examiner said SSD employees are singled out and spoken to if they approve too many claims. It is this culture that directly leads to innocent individuals quite literally dying for an appeal.
The Consequences of Long Wait Times
“The clients we see are undergoing extreme financial stress while they wait to hear if they will receive benefits,” says Jeffrey Freedman, managing attorney. “They struggle to put food on the table and keep a roof over their heads, often neglecting the medical care they desperately need due to the illness or injury that prevents them from working in the first place.”
As an SSD attorney, Kevin Bambury has also seen people in desperate financial circumstances while waiting for a hearing.
“This waiting period is financially devastating to most people,” Bambury says. “They may have no income coming in because they can’t work. These individuals quickly run through any savings they may have had because of medical expenses. Most lose their insurance when they stop working. They end up losing their homes, cars, and going without medical treatments that they desperately need.”
“One fellow was homeless, so he slept on his friend’s couch for two years before he received his benefits. Another woman ended up living in her mother’s basement,” Bambury says. “Yet another woman, who worked for 20 years, had to depend on her partner to pay their bills. Since her prescriptions were very costly, she went without rather than ask him to pay for them. This only worsened her condition.”
Not only is the wait time hard on finances, the stress and lack of medical care often make claimants sicker than they were when they applied. These are just a few of the local lives impacted by Western New York’s extreme wait time for SSD.
Susan’s Wait for Social Security Disability
“Susan” applied for SSD benefits last April due to mental health issues that prevent her from working. Her initial application, like two-thirds of all disability claims, was denied. With the help of an attorney, she applied for a hearing before an ALJ.
“Susan waited three months to hear that her initial claim had been denied, and it will probably be another 21 months before she has had her hearing and sees any benefits,” said Bambury. “More than a million people nationwide are waiting for a hearing – yet there are only 1,500 ALJs to process these claims.
“One thing the SSA has done to cut the wait time for claimants is authorizing staff attorneys to review cases and automatically approve those that clearly meet the criteria for disability. However, the rate of staff attorney approvals has now dropped because there aren’t enough attorneys – they are also overwhelmed with cases.”
Claimants like Susan, unable to work and without other income, suffer financial hardship while they wait. These individuals may qualify for Medicaid benefits and food stamps. However, this leaves them responsible for co-pays for prescriptions and non-food items.
Little Joy in the Holidays for Carolyn
For three years, Carolyn faced the holidays knowing she would not be able to provide any special gifts for her two sons. Carolyn, who lives in South Buffalo, is one of the thousands of Americans who applied for SSD benefits and is waiting for a hearing before an ALJ for a decision on their benefits.
“Carolyn had a good career for 27 years working with Tops Markets – up to the time she began to have panic attacks in early 2014,” said Freedman. “Her anxiety and depression worsened until she could no longer work. In December 2014, after she was denied SSD benefits on her initial application, we helped her apply for a hearing with an ALJ. More than a year later, we were still waiting for that hearing.
“There are about 1,500 ALJs throughout the country. Their job requires them to review medical records and other evidence – sometimes more than 1,000 pages – submitted by the claimant, state doctors, worker’s compensation doctors, and vocational experts,” Freedman said. “Between 2007 and 2013, requests for hearings spiked by 40 percent. That spike, combined with the number of ALJs and the length of time it takes them to process a case, was the beginning of a backlog that the SSA has not been able to resolve.”
The price is paid by people like Carolyn. She eventually suffered a heart attack from the stress of her illness and losing her job and income. The long wait times and lack of income create more anxiety for claimants who are already ill. Waiting often resulting in an increased need for medical care and treatment they can’t afford, according to Freedman.
“My oldest son was 20 when this began and my youngest was 12. The older one is now out on his own, but he still worries about me. This has been a long haul for both of them,” Carolyn said. “All of my family, including my husband’s sister, have been very supportive, but I feel badly about putting them through it, especially when the holidays come around.”
“These long waits are unconscionable. Carolyn worked for 27 years, paying into Social Security the entire time for a program that was supposed to be there for her if she should become disabled and unable to work,” Freedman said. This backlog of cases is not just a number. It needs to be eliminated. People like Carolyn should be able to get their lives on track and celebrate a holiday season without increased anxiety.
Years-Long Wait Finally Over for Larry
Larry, a 47-year-old former forklift operator from Tonawanda, received his first check from SSD at the beginning of December 2011. Due to complications from diabetes and depression, Larry had not worked since 2009. This is when he filed his initial application for SSD. Social Security determined his disability began in June 2009, when his doctors told him not to return to work.
“It’s very stressful,” Larry said. “My wife works but these days one breadwinner isn’t enough. We have had our water and gas shut off; we’ve had to use the food bank… Without help from our family and friends I don’t know how we would have made it through this past two and a half years.”
Gatti’s case is not unusual, according to Freedman. About two-thirds of initial applications for SSD are denied.
“The stress during those two and half years, though, definitely worsened my condition,” said Larry. “Even with the health insurance provided by my wife’s job, I ran up medical bills for co-pays. It was also stressful for my son and daughter (ages 20 and 18), who tried to help out as much as they could. I wouldn’t wish this on anyone,” Gatti said. “At least now I won’t have to rely as much on my family and friends.”
Financial Relief for Jamey
Relief came for Jamey, a 39-year-old who suffers from Multiple Sclerosis (MS), in March of 2012. For the previous two years, Jamey, a former moving company laborer, waited for his SSD claim to process. He lived with a friend in Cheektowaga to get by. “I’ve been borrowing from Peter to pay Paul,” Jamey said. “I expect to get a check for payments retroactive to March 2010. I can’t tell you what a huge burden has been lifted from my shoulders.”
Reducing Your Wait Time
Waiting years for a favorable disability decision has very few benefits. If you do experience an extended wait, your chances of a favorable decision may have improved by your hearing date. The lengthy process usually uncovers detailed medical evidence of your disability. Your condition could also worsen during the waiting period.
One of the best strategies for avoiding such a long wait is to apply for disability benefits with the help of a knowledgeable attorney who specializes in SSD benefits cases. They can help with the application process and assist you with the information the SSA needs to approve your claim. The first step is to make an accurate assessment of your work history, age, and medical condition. Second, we enlist the assistance and support of your medical team.
Jeffrey Freedman shares his thoughts on the topic, stating, “When people get turned down on their first application and they come to us, 85 percent or more are successful on appeal. It’s not because I’m a genius. It’s because they have legitimate claims that should be approved after their initial application.
“Although most of our clients have to go to the hearing level, in some situations we’re able to obtain benefits at the initial application stage. It’s important they get help early,” Freedman says.
During your wait for disability benefits, we encourage you to continue treatment for your medical condition(s)! Keep your appointments and follow up with specialists if instructed to do so. Do not skip physical therapy or counseling appointments. Take your medications as prescribed. If you are referred to a new doctor, undergo a procedure, or are hospitalized, let us know. That way, we can write to your treating providers and request the records from your visits to keep your disability claim moving forward as quickly as possible.