Winchester, TN Back-payment Case Highlights Problems in Social Security Claims Process

On Aug. 23, an 80-year-old woman finally received her Social Security back-payment. She had been homeless for years, living in Washington, D.C., and carrying three suitcases full of documents regarding her Social Security claim. After years of being repeatedly ignored or dismissed as a person who was mentally ill, a social worker took an interest in what she had to say, and helped the woman get the money she was owed – $99,999.

This case is an extreme example of how the Social Security Administration is bogged down with claims, understaffed, and unable to provide a quick resolution when people are in need of help. But with organized, thorough records and a willingness to keep pursuing their case, Social Security applicants may be able to prevail on their claims.

Types of Delays

When the Office of Disability Adjudication and Review closes a case, claimants may request a hearing to appeal that decision. As of July 2016, the wait time from the time of the request to the hearing date was between eight months and 26 months.

Claimants whose case goes before an Administrative Law Judge may request that the Appeals Council review an ALJ’s decision. The Appeals Council receives the appeal request, and may dismiss the claim, issue a new decision, confirm the ALJ’s denial of SSDI benefits, or remand to the ALJ for further action. Requests are classified as “pending,” when a claimant is awaiting a decision from the Appeals Council. In January 2016, 148,304 cases were pending; by the end of June, 136,228 cases were pending. In that same time frame, the council received approximately 9,000 to 13,000 requests for review every month.

The sheer volume of cases that continue entering the appeals process is causing serious delays in the decision-making process. And understaffing is only making the problem worse. In a three-year span, the SSA lost 11,000 employees, or 12 percent of its entire staff, and budget-related hiring freezes didn’t allow for replacing most of those former workers. Many remaining SSA employees will be eligible for retirement six years from now.

In March, the acting SSA commissioner told President Obama that claimants are now waiting longer to reach a representative via telephone, to get an appointment at a local SSA office, and to learn of a decision on their claim. In June, the SSA backlog of unresolved disability claims reached its highest level ever, with more than 1 million people awaiting news about their claim, and many field offices have closed in recent years, making it increasingly difficult for people to talk to anyone in person about their disability benefits.

The Effects of the Backlog

For the people waiting on disability benefits, the enormous backlog is putting them in a precarious position. Being unable to work, while still having to pay for the daily costs of living may result in serious and unmanageable debt – some people have actually lost their homes while waiting for the SSA to reach a decision on their claim. And some gravely ill claimants have died while waiting for benefits.

The best claimants can do is to keep meticulous records of their illness or disability and contact an attorney to help them with the SSDI application and subsequent appeals.

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