Backlog makes long wait for disability benefits

Kansans face hard road to receive benefits

Glenda Endriss, 51, cuddles Wednesday with her dog Beau at her home in Wellsville. Endriss stopped working in March of 2005 after having brain surgery to ease severe migraines. Since then, she has been denied social security twice and is awaiting her third hearing in October.

While waiting for his Social Security disability claim to be processed, Mark Reser’s children went without Christmas.

Debra Shirar – a one-time homeowner – has whittled her belongings down to $200 worth of clothes, family photos and a few pieces of antique furniture. She moved in with a friend.

Glenda Endriss, who once managed apartment complexes in Lawrence for the elderly and disabled, depended on her roommate for housing and her family for help.

Like many Kansans, the wait for disability benefits for Reser, Shirar and Endriss is measured in years, not months.

Kansas tops the list as the worst state in the country for backlogs of Social Security disability claims. According to data collected by the American Association of People with Disabilities and Allsup Inc., Kansas has nearly 15,000 people waiting for some kind of decision. The number is equal to 26.7 percent of the state’s beneficiaries.

Some use the state’s general assistance program as a bridge, getting a few hundred dollars a month to cover rent and food. They also can receive some health insurance benefits.

Marilyn Harp, executive director of Kansas Legal Services, has seen the wait for a hearing go from 18 months to two years.

“You are in a terrible catch 22. You don’t have any money, but if you work, then you’re not disabled,” Harp said.

The backlog also places a drain on state tax dollars as state services go toward helping those who are waiting for their disability claims to be accepted, said Rocky Nichols, executive director of the Disability Rights Center of Kansas.

Kevin Babbit, a Lawrence lawyer, tells his Social Security clients to prepare for a long wait before getting their first payment.

“It’s devastating,” he said. “Because, if you can imagine, the reason they are applying for benefits is because they can’t work and they have no money.”

The delay

According to Kansas Department of Social and Rehabilitation Services, it takes an average of 71 days for a determination to be made on a person’s disability. However, if the claim is denied in the first round – as the majority in the country are – the decision can be appealed and a hearing is set in front of an administrative law judge.

For Kansas cases, there are two hearing offices: Kansas City and Wichita. The wait for a hearing and subsequent decision in Kansas City is 628 days, nearly 21 months. In Wichita, the wait is 498 days, nearly 17 months.

Social Security Administration officials say the backlog is a combination of a lack of administrative law judges, an increased number of cases, a shift in the department’s workload and Congress’ continual under-funding of the department.

Judge Frank Cristaudo, SSA chief administrative law judge, says the agency knows the backlogs are a problem.

“We are not satisfied with how long it does take to issue a hearing decision, but it is based on the fact that we just don’t have enough judges and staff to handle the receipts we have received over the last number of years,” Cristaudo said.

Congress has marked $100 million more than what President George Bush has requested for the department this budget season.

If the money is approved, Cristaudo said more judges would be hired.

“It’s hard to say how many would go to Kansas if we had the authority,” Cristaudo said. “We would look at the numbers and try to balance this around the country, but Kansas is one of the priority areas.”

On appeal

But Babbit points to another problem: the amount of cases that are denied in the first round and then appealed. Nationwide in 2005, more than 60 percent of disability claims were turned down on the first consideration. Of those that were denied, around 25 percent were eventually approved, according to data on the SSA Web site.

“There shouldn’t be that many cases getting to that next level,” Babbit said.

Under a contract with SSA, Kansas makes the first determination on a person’s disability. If the state denies the claim, then the person can appeal it to the hearing office, which is overseen by SSA.

In Kansas, 68 percent of the claims in 2006 were allowed in the first stage, according to SSA data. Of the claims that were denied and went on to a hearing, 26.5 percent were approved.

Kansas had an accuracy rate that was greater than 95 percent in dealing with the initial claims.

“On the front end, we do really well,” SRS spokeswoman Abbie Hodgson said.

Between the original denial and the hearing, Cristaudo said often the applicant’s condition becomes worse or more medical evidence is gathered, making an approval more likely.

Social Security has a list of hundreds of aliments that automatically grant an applicant disability, such as blindness or mental retardation. But Cristaudo said it’s a list that needs updating.

Harp, whose agency is under contract with the state to help clients through the disability process, acknowledges that the first ruling is a hard one to make.

“It’s one of those programs where you have to hit all the rules. You have to get a yes in every box, or it is a no,” she said.

Harp said another reason for the backlog is that those who apply for the state’s general assistance program must also try for Social Security disability. While many of these people eventually get better and go back to work or retire, they are still in the system.

A timely yes

Not everyone has to wait years before getting their Social Security disability check.

Bob Harwood, Lawrence, said the process for him was surprisingly easy. It took eight months.

The former manager at CongAgra Foods was diagnosed with multiple sclerosis five years ago.

Although Harwood said he can “run, jump high and do somersaults,” he tires easily, can’t work for long periods, has trouble with his speech and has seen his cognitive abilities drop.

What helped his case, Harwood said, were the results of eight hours worth of testing at Kansas University Medical Center. He was participating in a research program and part of the study tested his cognitive functions. In one of the tests, Harwood failed a connect-the-dot puzzle under pressure.

He included the findings as part of the evidence to prove he could no longer work.

“I think the report slammed the door,” he said.

Stuck in the backlog

Others, such as Endriss and Shirar, are still waiting.

When Endriss gets her hearing in October, it will be two years after she applied for disability. Meanwhile, she moved from Lawrence to Wellsville.

In May 2005, Endriss had brain surgery to help ease severe migraines. Since then, the 51-year-old woman has had three more surgeries on her shoulders, and will have another on her back.

Shortly after brain surgery, Endriss applied for Social Security disability when her doctor advised her to stop working.

“I can’t work. They won’t allow me to work,” Endriss said.

After 40 years of working – often two or three jobs at a time – Shirar said it has been hard to ask for help. The 55-year-old has been a physical education teacher, prison guard, newspaper carrier and customer service representative.

After a combination of arm and back injuries with sleep apnea added in, Shirar applied for disability.

When a denial came in the first round, Shirar was told to expect a hearing in December 2008.

She is receiving general assistance and living with a friend rent-free, which helps her stay afloat in Lawrence.

“There is no way, with $144 cash assistance with $155 for food, there is no way, in Lawrence or any other town, I could survive,” she said.

Jean Peterson, associate professor of social welfare at KU, said for most people it’s a challenge to just take the step of applying for Social Security disability.

“The minute you make the decision, you really do give up hope that you’ll ever be able to get better,” she said. “And then, once you apply for it, basically, a lot of times you’re treated like you’re trying to put something over on someone.”

Peterson said that in today’s system, the cutoff for disability is far too black and white.

“Either you are disabled or you are not,” Peterson said. “There is no room to be able to do things that are productive and contribute.”

A weight lifted

At 45, Reser has a pacemaker and defibrillator in his heart. He suffers from blood clots and arthritis. For the former truck driver and construction worker, mowing the lawn is a challenge.

In his 28-month wait, Reser said a house bought on two incomes suddenly had to be paid for by one.

To get by, he borrowed money from family. Their teenage daughter started working so she could afford school clothes and activities. And Christmases were missed.

“Never in my whole life have I had to depend on anybody. I’ve always paid my bills,” said Reser, who lives in Topeka. “Now, I am depending on my in-laws and my own mom and dad. Here I am 45 years old and having to ask for money.”

As he waited, Reser said he received a letter from Social Security stating that if he showed proof of bankruptcy or foreclosure, his case could be fast tracked.

“You really got to be broke, living under a bridge or a box,” Reser said.

After asking U.S. Representative Nancy Boyda’s office for help, Reser said he received approval this month.

“There’s a whole bunch of weight off my shoulders,” he said.