Thursday, January 14, 2010

As House and Senate leaders work to resolve their differences on legislation that could massively expand the government’s role in health care, it is worth considering how another program intended to help the most unfortunate among us treats the people it is supposed to serve.

Congress created the Social Security Disability Insurance (SSDI) program in 1956 to protect Americans who became disabled and could no longer work. We, along with our employers, pay into the program through a portion of our payroll taxes. Persons who become permanently disabled are eligible for benefits if they have worked and paid into the program for at least five of the past 10 years. An added bonus: Those who qualify for disability benefits also become entitled to Medicare coverage after 24 months.

In the face of the highest unemployment levels in 25 years, desperate Americans are flooding the Social Security Administration (SSA) with disability insurance claims at an unprecedented rate. This massive influx of new claims is poised to crush a system already so overwhelmed that applicants, after being denied disability benefits, wait an average of nearly 17 months in the District just to appear before a judge who will hear their appeal and determine whether they will receive benefits.

Nationwide, nearly three-quarters of a million Americans are stuck in the disability backlog, unable to work, watching their savings drain away and hoping the government will get to their case before it’s too late.

Many people will hear the new application numbers and assume it’s an issue of fraud, which is a fair assumption to make, but those who have some experience with SSDI understand the picture isn’t that black and white.

As difficult and time-consuming as the disability application process is, it’s no surprise so many people try to avoid it at all costs. A process that can involve more tests and examinations, hearings and mountains of complicated paperwork - all for an uncertain promise of help that could be years away - is a huge added burden for someone already dealing with significant health problems.

However, when the weak economy hits close to home, ill people who have tried and lost the battle to hold onto their jobs often realize they can no longer afford to live without the disability benefits for which they have paid. Perhaps the spouse who had been supporting the family suddenly loses his job. Or the child who had been helping gets downsized.

Only after qualified people apply do they realize just how far off the assistance can be. According to a nationwide survey of successful SSDI claimants by Allsup Inc., an overwhelming majority of applicants face grave financial crises, personal setbacks or health downturns while stuck in the federal disability backlog.

Almost 90 percent of these applicants said they faced negative repercussions from the delays they experienced before they received their SSDI award. These included worsening illness, drained retirement funds or other savings, loss of existing health insurance, missed mortgage payments and even foreclosure and bankruptcy.

As a long-term fix for this immense backlog, more resources need to be provided to the Social Security Administration. However, a simple, cost-free step could make an immediate difference. Because applicants are new to the SSDI process and often don’t know help is available, too many initial claims are denied for simple mistakes that have nothing to do with the applicant’s disability status.

In other cases, applicants who don’t meet the standards for disability - but might if their conditions worsen over time - bog down the system when simple pre-qualification support would let them know they aren’t ready yet.

Congress and the president should immediately direct the SSA to notify applicants that they have options when pursuing their claims. Expert disability representatives work exactly like tax professionals to help guide applicants through a complex government process, create a complete filing, comply with the rules and laws (reducing fraud) and advocate for them before a federal agency. Notifying applicants that they have the option of representation is similar to the Internal Revenue Service’s acknowledgement of tax preparation professionals.

Many hundreds of thousands of government worker-hours would be saved - and existing SSA staff could get back to helping more people faster - if more applications processed by the SSA were professionally reviewed, documented and prepared before they were submitted to the government agency - with the potential to help alleviate mandatory furloughs for SSA employees in at least nine states.

Jim Allsup is founder, president and chief executive of Allsup, the country’s largest non-attorney SSDI representation company.

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