For years you’ve paid insurance premiums to protect yourself against unforeseen health problems. Yet when an accident or serious illness strikes, the insurer refuses to pay up.
That’s essentially theft, the kind of thing people expect the government to step in and stop.
But in this case, it is the government itself — Social Security, to be precise — that is cheating ailing and injured people out of the money to which they are entitled.
As detailed in a story in Sunday’s Kansas City Star, Social Security is victimizing large numbers of people by delaying their disability payments or refusing to pay them at all.
It’s an outrage.
The government is not simply cheating people, it is cheating them at a point in their lives when they are perhaps more vulnerable than they have ever been: financially vulnerable, physically vulnerable and often psychologically vulnerable.
Missouri and Kansas residents appear to be at higher-than-average risks of unreasonable delays.
The critical problems:
-- The application process is far too complicated, raising the risks of lengthy delays and unreasonable denials. Some people feel they must hire someone else to handle all the complexities, and such help is often quite expensive.
-- Social Security’s processing backlogs delay payments to people who need their money immediately. Disabled Kansas Citians who apply for benefits now may not get them, on average, until late next year.
-- Some people who deserve benefits never get them.
Government officials promise to do better. But some of the steps that have been announced seem like things that should have been done long ago: adding staff, recognizing the severity of certain illnesses and so on.
Social Security isn’t optional for the people who pay into it. That places an even higher moral burden on the government to provide the promised benefits quickly.
Because Social Security’s concept of “disability” is so restrictive and because it handles claims so poorly, experts advise people to buy private disability insurance as well.
That’s a sad commentary on the current situation. It is also very good advice.
Delicious
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SS and Medicare Trustees Report
I agree with Paul Krugman, Princeton economist and columnist, that the situation in SS is not dire, but that Medicare needs attention. As Krugman pointed out, the trustees report shows that the fund increased last year more than predicted due to the increase in immigrants. As the Star editorial pointed out, the payroll taxes that support SS are projected to run short in 2017. After that, however, SS will start drawing on its trust fund which is projected to be exhausted by 2041, all things remaining equal. (By that time many of the baby boomers will have died.) After the trust fund is depleted payroll taxes will pay 78 percent of current benefits. The problem is not with Social Security, but with the large deficit the US is running which may make it unable to pay what it owes to the recipients.
For those who are interested in a cogent explanation, I would refer them to a book by KC's own Max J. Skidmore, UMKC, entitled Social Security and Its Enemies. Another excellent one is Social Security: The Phony Crisis by Dean Baker and Mark Weisbrot. Both are short and free of academic jargon.
Jeanette
Social Security Disability Payments
Back at the beginning of the Reagan administration, I went to the SS Office in KC, with a new Ph.D. in public administration in hand, to apply for a job. I was told that the Reagan adm. was cutting employees and there would be no new hires. I've kept my eye on this office since then, and as I understand it, the cuts have continued. The truth is that funds have been diverted from almost every government service to fund the military machine, particularly since the war in Iraq. There is nothing the matter with SS benefits for the disabled that could not be mended with an adequate staff to take care of the claims. The tragedy is that all of the money that has been diverted and sent to Iraq has been wasted. The poor Iraq people, except for a few corrupt officials, are much worse off than they ever were under Saddam.
Jeanette
You should know the facts.
Thanks to SSDC for the research.
I say again; Is this what you want America’s health care industry to become?
Once again Ms. Tiller has failed to research her statements. Let me help you.
First, saying “government employees plan” is in itself an error compounded by calling it a national plan. There is no one plan. Federal employees have a choice of several plans. (http://www.opm.gov/insure/08/planinfo/mo.asp) The government uses its buying power as leverage to secure better rates from PRIVATE INSURERS for those enrolled. The employee does have choices for the amount of coverage, the type of plan, the provider etc… Premiums, for the most part come from the employees themselves and the wages that they earn. They mostly have deductibles and out of pocket co-payments. Dental and vision are usually extra. In a true national plan all taxpayers would cover these costs and the federal government would be the single payer. This simply is not the case here.
Second, Medicare works pretty well? If you say so, but even The Star reported not long ago that Medicare routinely pays 4 to 5 times the amount for equipment and services compared to private insurers. Costs are completely out of control and there is great concern about whether there will be enough money to cover the baby boomers. Multiply all of this by roughly 3 times to cover the entire country and it becomes three times more costly and confusing.
Third, and I’m glad you brought this one up, the military plan. This is not really a plan but rather a government agency. It’s called the Veterans Administration. This one truly is a government entity with its own hospitals and doctors. This is the response to a promise made to those who serve our country in the military. It is a debt that we all owe to the brave men and women who have worn the uniforms of the armed forces. On the surface it looks pretty good but when you look closer you will see many problems with sub standard and sometimes unclean hospitals. Delays in getting appointments and treatment are common. It is a disgrace that we don’t do better by our veterans but there simply never seems to be enough money.
Finally, your last comment, “Are you suggesting we dump those?” describes the problem in a nutshell. Once you get people on the government entitlement list they become dependent. Because of that dependency that particular entitlement can never be ended or cut back no matter how costly or inefficient it becomes. Everyone knows Social Security needs to be reformed but so many dependent people raise such a clamor every time the topic comes up that it never comes to fruition.
The government simply cannot be our caretaker from birth to death.
Ross Balano Midwest Voices 2008
Social Insecurity Disability Nightmare!
During 2006 and 2007, at least 16,000 people fighting for Social Security Disability benefits died while awaiting a decision (CBS News Report – Disabled And Waiting - 1/14/08). This is more than 4 times the number of Americans killed in the Iraq war since it began.
During 2007, two-thirds of all applicants that were denied - nearly a million people - simply gave up after being turned down the first time (CBS News Report – Failing The Disabled - 1/15/08)
In 2007 there were 2,190,196 new applications for SSDI benefits, and as of February 2008 there have already been 379,164 new applications.
There are about 1,585,203 total pending cases and out of that number, 154,841 are veterans.
Nationally as of February 2008, over 64% of Social Security Disability cases were denied at the initial stage of the disability claims process and it took from 104.8 – 114.3 days for claimants to receive the initial decision on their claim.
If a claimant appeals the initial denial asking for reconsideration, in all but 10 test states where the reconsideration phase has been removed, 86.7% of cases were denied and the waiting time for this phase was an average of 88.4 days.
As of February 2008 - 751,767 are waiting for hearings with an average wait time of 511 days
Nearly 300,000 hearings have already been pending over a year, and there are only 995 Administrative law judges (ALJ’s), to hear all those cases, with an average of 735.88 cases pending per judge nationwide.
Two-thirds of those who appeal an initial rejection eventually win their cases (New York Times 12/10/07)
According to Health Affairs, The Policy Journal of the Health Sphere, 2 February 2, 2005: Disability causes nearly 50% of all mortgage foreclosures, compared to 2% caused by death.
MarketWatch: Illness And Injury As Contributors To Bankruptcy - February 2, 2005 – found that: Over half of all personal U.S. bankruptcies, affecting over 2 million people annually, were attributable to illness or medical bills. 15% of all homeowners who had taken out a second or third mortgage cited medical expenses as a reason.
According to a National Academy of Social Insurance (NASI) report “Social Security Is Worth $225,000 for a Typical Retiree
Here is just a small sampling of some of the major problems with the current Social Security Disability program and State Disability (DDS) offices who process the initial phase/medical portion of disability claims:
Severe under staffing of SSA workers at all levels of the program Claimants waiting for weeks or months to get appointments, and hours to be seen by caseworkers at Social Security field offices Extraordinary wait times between the different phases of the disability claims process
Very little or no communication between caseworkers and claimants throughout the disability claims process before decisions are made.
Employees being rude/insensitive, not returning calls, not willing to provide information to claimants or not having the knowledge to do so
Complaints of lost files and in some states, case files being purposely thrown in the trash rather than processed properly
Security Breaches - Complaints of having other claimants information improperly filed/mixed in where it doesn't belong
Fraud on the part of DDS/OHA offices, ALJ's, IME's – purposely manipulating or ignoring information provided to deny claims, or doctors stating that they gave medical exams to claimants that they never did.
Claimants being sent to doctors that are not trained properly, or have the proper credentials in the medical field for the illnesses which claimants are being sent to them for.
Complaints of lack of attention/ignoring - medical records provided and claimants concerns by Field Officers, IME doctors and ALJ's.
Employees greatly lacking in knowledge of and in some cases purposely violating Social Security and Federal Regulations (including Freedom of Information Act and SSD Pre-Hearing review process).
Claimants cannot get through on the phone to the local SS office or 800 number (trying for hours even days)
Claimants getting conflicting/erroneous information depending on whom they happen to talk to at Social Security - causing confusion for claimants and in some cases major problems including improper payments
Proper weight not being given to claimants treating physicians according to SSA Federal Regulations when making medical disability determinations on claims.
Complaints of ALJ's "bribing" claimants to give up part of their retro pay (agreeing to manipulation of disability eligibility dates) or they will not approve their claims
Poor/little coordination of information between the different departments and phases of the disability process
Complaints of backlogs at payment processing centers once claim is approved
Federal Quality Review process adding even more wait time to claims processing, increasing backlogs, no ability to follow up on claim in this phase
NOTE: These complaints refer to all phases of the SSDI claims process including local field offices, state Disability Determinations offices, CE/IME physicians, Office of Hearings and Appeals, the Social Security
main office in MD (800 number).
Social Security Disability Nightmare – It Could Happen To You!
http://www.frontiernet.net/~lindaf1/SOCIALSECURITYDISABILITYNIGHTMARE.html
Social Security Disability Coalition – offering FREE information and support with a focus on SSD reform:
http://groups.msn.com/SocialSecurityDisabilityCoalition
Social Security Disability Reform Petition – read the horror stories from all over the nation:
http://www.petitiononline.com/SSDC/petition.html
Fullerton - Edwards Social Security Disability Reform Act:
http://groups.msn.com/SocialSecurityDisabilityCoalition/fullertonedwardssocialsecuritydisabilityreformact.msnw
fixing Social Security Disability system and national health
Denise Tiller, Midwest Voices 2008
I agree the Social Security Disability system needs some major changes--the rules are too complex and waiting is unfair. Sadly, it's not just the Social Security System, this weekend I was listening to a story on NPR about the horrible way our disabled servicemen and women are being treated. It's outrageous.
I understand that defining disability is far more difficult than defining death or illness, but it can be done in a fair manner. It takes properly trained and compassionate claims people. It can be done.
As for Mr. Balano's comments about national health care--actuarially speaking they are two different programs. Again, it's difficult to define disability, sickness is easier and usually of a shorter duration. We have several national health care systems that work pretty well--Medicare (except for the prescription drug benefit thanks to the Republicans making it illegal to negotiate drug prices), the military plan, and the government employees plan. Are you suggesting we dump those?
Denise Tiller
Midwest Voices Panel 2008
And yet...
And yet you still want the government to take over the health care system.
Ladies and Gentlemen: Please read Yael’s editorial and ask yourself if this is what you want the health care system to become.
Ross Balano Midwest Voices 2008