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SSDI’s Problematic Delays & Denials

Social Security Disability Insurance (SSDI) provides benefits to disabled workers who can no longer work. Many people each year depend upon the SSDI program: Single workers, families with children, dual income couples, and many others.

Applicants who apply for SSDI are unable to work due to an illness or injury, but contributed to the SSDI program for years via payroll taxes while they were able to work. Still, many are forced to wait years to hear back when they apply for benefits.

 

The Many Stages of Waiting…

In order to file for disability, one fills out an application at the agency and has a physical exam. After the exam, the initial application decision typically comes within two or three months.

However, approximately one-third of those claims are denied. And as a result, most appeal. This is where a significant amount of the waiting occurs. The average wait for an SSDI initial claim is 110 days. More than two-thirds of these end up needing to be reconsidered, leading to an average wait of 103 days. After this stage, an average of 12 percent of applicants are granted benefits, and wait an average of 583 to 605 days. Reportedly, 7,400 people have died waiting for their disability hearing.

One man’s story highlights the sheer unfairness of so many applications that get rejected each year: After working on his feet for most of his life and paying into SSDI, Ted Grohowski, suffering from infected ulcers on his feet, a knee replacement that is falling apart, and a kidney problem (his kidney had to be removed due to cancer), was denied SSDI. In order to appeal the decision, he may have to wait two years before appearing before a judge and stating his case.

 

Catch-22

What’s potentially even worse is the “bind” that the program arguably puts applicants in: someone claiming disability is encouraged not to work from when they request a hearing and get that hearing in front of the judge. This effectively means that in order to qualify for the program, one must go months, into years, without any income, which is essentially impossible for families. If you earn income beyond the “substantial gainful activity” limit, it is assumed that you can do a substantial amount of work, and you won’t qualify for the program.

This is also a catch-22: by not having any income, many are unable to go to the doctor. However, not going to the doctor for months or years makes it appear as though an applicant doesn’t have an actual disability.

 

2017 Trustees Report: Social Security Disability Insurance Running Out Of Time

On July 13th, the Social Security Administration trustees released a report indicating that the Social Security Disability Insurance Trust Fund will be insolvent by 2028, in 17 years. Although it currently has an asset total of $2.85 trillion (when combined with the Old-Age and Survivors Insurance Fund), and it is growing every year, the cost of the program is still expected to outweigh the revenue by 2022, and funds are expected to be completely depleted by 2034. Policymakers will need to act fast if they expect to keep the program running while possible even strengthening the program’s finances.

What happens when it runs out? Benefits would be scaled back to match whatever annual amount is contributed through related payroll taxes (which will be significantly less than what today’s taxpayers are expecting). Even now, fewer than half of all applicants receive the benefits that they have paid for and need.

 

Moving Forward?

This is unacceptable and is, in part, due to the Social Security Administration not having a leader in place since 2013. Lawmakers have also constructed various barriers to funding the program, requiring extra, unnecessary steps to muddy the claims process; often refusing to honor the opinions of applicants’ personal physicians.

Experts have suggested that the Administration hire temporary staff, increasing reliance on on-the-record decisions which do not require in-person hearings, and prioritize both those who have been waiting the longest for a hearing and/or are the sickest in order to address the backlog. In addition, permanent leadership in the form of a Senate-confirmed Social Security commissioner is arguably sorely needed.

The continual cuts to the program have contributed to the backlog, and in addition, the current administration has now proposed additional cuts totaling $64 million. The 2017 report pointed out that additional options—such as increasing SSDI payroll taxes now or cutting benefits—would have to involve drastic, draconian measures that lawmakers are unlikely to take. However, by waiting, lawmakers only make fixing the program more difficult.

 

ABLE Accounts & How a Social Security Disability Lawyer Can Help

If you cannot work because of an illness or injury and expect to be unable to return to work for at least a year, you may want to apply for SSDI benefits. An SSDI attorney can help you in this endeavor.

SSDI attorneys can also help you establish an ABLE account. ABLE accounts are tax-advantaged savings accounts for people with disabilities. They can be used to cover disability expenses such as education, transportation, and housing. Anyone who develops a qualifying disability before the age of 26 can open an ABLE account and contribute up to $14,000 per year as long as you meet Social Security’s definition of having “severe functional limitations” with an onset prior to 26 years of age. In addition, those who are already receiving benefits under the SSDI program prior to age 26 are automatically eligible to open an ABLE account. Louisiana is one of the many states that have adopted the ABLE Act.
Our SSDI lawyers in New Orleans can help you apply for SSDI benefits, appeal a denial, or help you with any other aspect of the SSDI program. Contact us today to set up a consultation.

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