Many Wisconsin disabled people have the longest wait for Social Security benefits

From The Wisconsin State Journal:

MARSHALL, Wis. -- Ross Pettey (pictured) likens his body to a "totaled-out car."

But in spite of his three past back surgeries, a lung surgery, a bad shoulder, and a diagnosis of hepatitis C and pancreatitis, the former factory worker so far hasn't won federal disability payments.

For two years, Pettey, 49, has struggled to get by while his Social Security disability case crawls through a bureaucracy that can take years to settle claims by disabled residents that they're unable to work, especially in Wisconsin.

A Wisconsin State Journal investigation found the thousands of claimants in the state have some of the longest waits in the nation. The investigation uncovered claimants who have lost a home and savings, saw a marriage deteriorate and even attempted suicide as they waited on a system that approved their claims only after years of suffering.

"I can see where it tears up families. They lose everything waiting for the government," Pettey said. "Why does it take so long?"

Even Social Security commissioner Michael Astrue calls the waits "inexcusable," saying efforts to address them are being complicated by the national economic downturn and the disabling medical problems of baby boomers that are making more people turn to the program.

And plans by Gov. Jim Doyle's administration to furlough federally funded workers who are part of the system could also make the problem worse while failing to save state taxpayers a dime, Astrue said.

Social Security disability insurance benefits average $1,062 a month, along with eventual health coverage, and are given to millions of Americans who qualify in part because they're found too disabled to work. They differ from shorter-term unemployment benefits because unemployment recipients must look for work.

The State Journal review found:

•Following a national trend, in Wisconsin the number of disability cases waiting for an initial decision has risen by 25 percent to 14,379 so far this year.

•At just one level of the later appeals process, a request for a hearing before a federal administrative law judge, the average wait at the Madison office this year has been 688 days - almost two years. That delay is the second-longest among the nation's 142 hearing offices.

•At the end of this nearly two-year wait, most struggling claimants like Pettey are found to deserve benefits. At the Madison hearing office, 59 percent of claimants win their appeal before the administrative law judge.

•Because of this hearing level backlog, cases from at least six Wisconsin counties are being sent to offices in California. That can speed up claimants' cases but only if they agree to hold their hearing with the judge by teleconference, not in person.

•Ailing claimants can have difficulty correctly filing the complex applications without help, leading to denials and adding to the delays.

In an interview, Astrue, the head of the Social Security Administration, said his agency had been underfunded in past years and didn't provide enough resources in states like Wisconsin and Michigan, where the downturn in manufacturing has added to the number of claimants seeking benefits. The Milwaukee office and its satellite office in Madison also aren't productive enough, he said.

Astrue said Congress and the agency are providing more resources. The Madison office will become a full hearing office by September 2010, increasing its administrative law judges from two to six.

"It's frustrating. I don't want to justify where we're at now as justifiable," Astrue said of the hearings backlog, which he wants to end by 2013. "But it's getting significantly better."

The state Department of Health Services handles claims in their early stages, where the wait for initial decisions stretches more than three and a half months. Jason Helgerson, a top agency administrator, said state employees handling these claims are being required to work more quickly and work overtime to end an "unacceptable" backlog.

The waits can be agonizing for applicants like Doreen Rheingans of Green Bay.

Rheingans, 47, has struggled for decades with chronic depression and more recently with chronic pain. After receiving disability benefits from the age of 16, she lost them in 1999 because an agency review found her able to work. But Rheingans said she wasn't able to hold a job.

She said she reapplied for disability benefits in August 2004, receiving four denials as her appeal went on and her condition worsened. She filed a second application and had it approved in November 2008, more than four years after the filing of her initial claim.

After living for four years on public housing assistance and food stamps, Rheingans said she now owes some $50,000 in credit card and medical debt.

Overwhelmed by the untreated depression, pain and financial worries, Rheingans said she tried to end her life in November 2007 by taking dozens of sleeping pills. Her adult daughter called for help in time for emergency medics and doctors to save Rheingans' life.

"I knew I needed help. I just couldn't get it. I had no insurance," Rheingans said.

Janelle Walton, a disability benefits specialist with Brown County who has worked with Rheingans, confirmed the attempted suicide and hospitalization. She said she believed Rheingans had a "good claim" and said she had seen other applicants struggling not just financially but mentally.

"They're in despair. They don't know where to turn or what to do," Walton said.

Bobby Peterson, executive director of the Madison non-profit ABC for Health, said sick claimants often need the help of a county worker like Walton, a lawyer or a group like his to make it through the complicated bureaucracy. Dan Allsup, a spokesman for the Illinois company Allsup Inc., which helps claimants for a fee, said the system would also work more quickly if more applicants used firms like his to ensure their application is done correctly and completely the first time.

Pettey of Marshall said only long-term disability insurance from a former employer has kept him from becoming homeless. Scars from the past back surgeries cross his back, the legacy of a May 2008 car accident and a lifetime of heavy lifting in factory jobs.

Pettey is able to do limited work around his house and has considered getting vocational training. But he said he also must rest after only an hour or so of odd jobs.

Pettey applied for disability benefits in the fall of 2007 and is still waiting on an appeal of his first two denials. He was told in July 2008 he would get a hearing date with an administrative law judge by July 2009, but two months later he hasn't heard anything.