Stuck in Limbo – What Creates the Social Security Disability Backlog and How to Avoid It

Donna Joe

With more than a million backlog cases and waiting periods of almost two-years, many applicants won’t live long enough for their hearing. We explain the reasons behind the backlog and explore possible solutions.

This is the second part of our two-article series on the Social Security disability backlog. To read the first part, click here.

In our previous article on the Social Security disability backlog, we recounted the struggle of Joe Stewart and his almost 600-day wait for his disability hearing. We also mentioned that Stewart’s story is hardly unique – over a million people are stuck in the limbo of the disability awards and appeals process, created by an enormous backlog of cases. In this article, we will analyze reasons for this situation and explore potential solutions to the problem. We will also offer practical suggestions for those who need to apply for Social Security disability benefits and want to avoid the backlog.

How Does The System Work?

What exactly is producing such disastrous backlog of cases? There are a couple of reasons but in order to understand them well, one first needs to have a grasp of how the application process works. Two types of government programs for the disabled exist – Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). The former – SSDI – is designed for the people with strong work history who have consistently paid into the Social Security system for a number of years. The latter – SSI – is for the disabled poor, people below a certain level of income who weren’t able to pay Social Security.

Both groups need to submit an initial application to Social Security Administration along with their full medical history. Millions of people file such applications each year. They wait up to 3 months for the initial decision. Only a third are awarded benefits at this stage.

The rest of the group – about 70% – have a period of 60 days to appeal the initial decision with the SSA. This is called the reconsideration stage. The waiting time is 3 to 5 months. According to The Washington Post, the appeals of only 10% of those who apply for reconsideration are granted.

For the rest, the battle for their benefits is still on. They may further appeal the SSA’s decision and apply for a hearing before an Administrative Law Judge. This is where the ever-growing backlog of applicants exists. In 2012, the national average wait time for the hearing was 350 days – by the end of the 2017 fiscal year, it reaches almost 600. The bigger the backlog, the more people will die waiting for the hearing and the decision (according to The Washington Post, the number has grown from 8,700 in 2016 fiscal year to more than 10,000 the fiscal year 2017).

Beyond The Budget Cuts

The simplest explanation for the backlog is also the least surprising one – there simply isn’t enough money. While the number of applicants grows each year, the funds allocated annually for the two benefit programs hasn’t changed since 2010. However, more complicated factors are at play. First, more judges are needed. SSA has tried to address this issue and is reportedly working to hire 500 additional judges and more than 600 support staff, according to the Associated Press. The Washington Post also mentions that a less than stellar economy in the last few years may be one of the culprits. But the newspaper also points out to two additional factors.

First, a new regulation requires more medical evidence to be presented. More medical records mean that a judge needs to spend more time reading and analyzing them. Second, the process is now subject to more scrutiny as a result of a 2011 scandal where one judge was found guilty of taking $600,000 in bribes in exchange for granting the appeals. The Washington Post notes that since then, the number of cases the average judge is able to decide dropped from 12 a week to 10 a week. Although this may seem like a small decrease, multiplied by hundreds of weeks and hundreds of judges, it results in the ever-growing backlog of cases.

 

How to Avoid The Backlog – on National and Personal Level

So what can be done to address this issue? According to Sen. Ron Wyden, mentioned earlier, everything is in the hands of the Congress. “Congress should provide sufficient administrative funding in its upcoming appropriations bill so those who are eligible can receive disability insurance in a timely way”, wrote Sen. Wyden in the letter to The Washington Post. He also suggested that the additional funding should be used to “make case-management systems updates, [and] ensure that the agency has enough evaluators and administrative law judges to process claims”.

This past September, the Social Security Administration promised to take steps to reduce the current waiting period by half by 2022. Many see these measures as inadequate. After all, tens of thousands of Americans, many of whom are potentially eligible for the benefits, will die before the promised measures are in place.

For those who haven’t yet applied for SSDI or SSI, the best chance to avoid the crushing backlog is to present a strong case at the initial two stages of the application process. The best way to ensure that is hiring an experienced social security disability lawyer. Our attorneys at Marasco & Nesselbush have helped many people obtain the benefits they deserved. Thanks to our help, a considerable number of applications were granted SSDI or SSI after filing their initial application. We are committed to helping applicants to avoid the crushing backlog or to successfully pass the hearing before an Administrative Law Judge. Please contact us today to obtain a free consultation on your case.