In upstate NY, it can take a year for disabled people to get their SSDI

From The Democrat-Chronicle:

Rochester and other western New York residents who file for Social Security Disability Insurance continue to play a waiting game.

While additional administrative law judges were hired nationally last year, it still can take a year or more to get a hearing that will determine whether or not the person receives benefits.

Through Jan. 31, the average time to get a hearing in the Rochester satellite office of the Social Security Administration was 445 days and 3,118 cases were pending. The average processing time for the Buffalo office, where local residents also have cases heard, was 578 days. Nearly 7,000 cases were pending, and about 1,000 cases had been moved to other offices for disposition. The data was analyzed by Allsup, a for-profit company headquartered in Illinois that represents people filing for SSDI.

At the end of January, the average wait time in New York was 465 days, 18th worst in the nation. The range nationwide was 299 to 590 days. More than 33,000 cases were pending in the state.

In the time it takes to get a decision, people's lives can completely change.

"People are dropping dead," said Linda Fullerton, 54, of Rochester, who suffered a disabling injury in 1996 after bumping her head while getting out of a car, and a blood clot between her scalp and skull became infected. In December 2001, she became unable to work and filed a disability claim. It took 13 months for her to receive benefits, and she has since become an advocate. "I lost a friend locally. He died waiting."

She depleted her savings and went without medical care because she couldn't pay for it.


"It's devastating. In my case or many others, you never recover."

Rick Warsinskey, past president of the National Council of Social Security Management Associations, says that technology, and hiring and improving the training for staff are cutting wait times. Warsinskey, who works for the Social Security Administration in Cleveland, said that he does not speak on behalf of the agency.

Despite recent progress, overall the caseload is up and the wait still is measured by the calendar rather than a stopwatch.

SSA data showed that through March, the wait time in Rochester was 353 days and in Buffalo it was 554 days.

The wait times were for cases that had initially been denied and the individuals had appealed. In New York, 56 percent of claims initially are denied. The data does not include the time it takes to get the initial ruling. A person has to wait five full months after they are disabled before they can get Social Security Disability.

John Shallman, regional communications director for the SSA, said that the backlog stems from limited resources and an increased demand for all Social Security services as baby boomers age. Shallman also said that the agency was slow to embrace new technologies.

Shallman said that the agency is in the process of hiring 900 front-line workers, but acknowledged that it can take a year or more for them to be fully proficient. Additionally, he said that there are plans to add 25 hearing offices and hire 226 more judges and more support staff.

Warsinskey said that the backlog is a tragedy. He said that an acceptable amount of time from initial filing to hearing a decision would be about nine months. He said that the SSA had hoped to clear the backlog by 2013.

"It's like turning a battleship around," he said.

Filing for disability can be confusing, time-consuming and lead to mistakes, which can be reflected in the backlog.

"This whole process is so nebulous," said Fullerton. She said that people may think they need only say they have an ailment. "Social Security is looking for functionality. How does what you have keep you from doing daily activities or any kind of work in the national economy? How long is the disability expected to last?"

Claimants have to meet strict requirements, which include having worked for five of the previous 10 years. In New York, the claim initially goes to the Division of Disability Determination, a state agency, where the medical decision is made. Approximately 45 percent of all claims are approved at this level, according to Warsinskey.

If the claim is denied, it goes through a review process.

Shallman said a common reason for denial is that it's determined that the person can work, even if not in his or her original job. Shallman said that the goal is to make that initial determination in 90 days and that claimants are told to expect a decision within three to five months.

If the claim is allowed, the person will begin receiving benefits after a five-month waiting period. If the claim is denied, individuals have 60 days to file an appeal.

New York is one of 10 states where claimants can go straight to a hearing without having to take a middle step called reconsideration. Shallman said he didn't have data to support how bypassing reconsideration affected the wait time.