Once upon a time …

bigstock-Text-Once Upon A TimeOnce upon a time a very bad and lazy man applied for Social Security benefits, and even though he had only very minor health issues, in short order, he received his disability checks, and lived happily ever after.  The end.

We read this story in the press every day.  It’s a well-known narrative – simple and complete – accepted as common knowledge.   But, it is completely false.

Anyone who has gone through the Social Security disability process knows that it is false.  Full length portrait of an embarrassed naked man in underwear, iAnyone who has ever been in a courtroom with their medical records splayed out before a judge confessing under oath their “functional deficits” with a vocational expert in the courtroom testifying to what jobs this person could do, and a medical expert hired to testify how the person does or doesn’t “meet a Listing”  … knows that it is patently false.

Proving your disability is no fairy tale.

Yes, there are people who commit fraud – just like there are folks who shoplift in the grocery store.  But the fact that there are those who shoplift groceries doesn’t mean that honest shoppers can’t complain about the high price of breakfast cereal.

When disabled people who are really and truly suffering, go through the many, lengthy, time-consuming, and humiliating steps they must go through to acquire Social Security disability benefits tell their stories – they are not heard.  They are prejudged as frauds, folks turn away saying in essence, “the price of breakfast cereal doesn’t matter, you’re probably just a shoplifter anyway!”

One barrier to the press being able to tell an accurate story about really and truly disabled Closeup portrait of troubled man looking at camera, worried.people is that really and truly disabled people are loath to tell what is really and truly wrong with them.  It is embarrassing.

Another barrier to the press telling the story of really and truly disabled people and what they go through to receive disability benefits, is that it’s not fun to write about and it’s not fun to read about.

Writing the stories of disabled people who are in the process of applying for Social Security disability requires the press to research the statute, the regulations, read court decisions, medical records, digest statistics.  It’s complicated, and …  bo-ring!

Reading about really and truly disabled people and what they go through to receive disability benefits requires considering people in pain, people in and out of hospitals, people battling health insurance companies, people enduring the waiting rooms of clinics trying to get medical care when uninsured, people losing homes to foreclosure, people sending their children to live with relatives while they descend into poverty ….  Depressing.  Blech.  Who wants to read about that?

But … who doesn’t love a good fraud story???  Those are simple, straightforward, and better yet – salacious!

Writing about fraud is fun!  Reading about fraud is fun!

Even I love those stories about folks who bury deceased relatives in the backyard just to keep receiving their Social Security checks.  Part of the fun is they’re so … Jerry Springer!   Imagine … carrying the body of a loved-one to the backyard, digging and digging and digging – maybe even in the cover of darkness.   Can you do that by hand?  Do you have to rent a back hoe?   Think of the logistics.  Think of actually tossing that body in.  Gah!   It’s ludicrous … and so uncommon as to be statistically irrelevant – but that’s what reporters write about.  That’s what people read about.  And the public is up in arms!  Dammit!   I’m up in arms!

That’s why I use titles like “Good morning you loser piece of dung, good-for-nothing, fraudulent drain on society … how can I help you?”   I’m just trying to compete.

In the “once upon a time” story of the bad and lazy man who applied for Social Security benefits … he received his benefits “in short order” and that is a key piece to the erroneous story.  It is important that the reader/listener of a story believe it is a snap to apply for and receive disability benefits.  Spit spot, you apply, you get it, you’re on vacation for life!

PrintThe time it takes to resolve a disability case is not measured in months – it is measured in years.  Years and years and years.  And not just years and years and years, but hard years and years and years.  Hard because you have no income, or precious little of it.  As I have written before, I have never figured out how people actually manage to live with no money.

One client I had was a woman in her fifties who, while her case was pending had become homeless.  Homeless, like so many people who have applied for disability and are hoping and praying and waiting.  She came to my office to prepare for her hearing before an Administrative Law Judge.  It was summer, she was wearing shorts.  I noticed she had quite a number of bruises … especially on her inner thighs.  I asked her about them, and she evaded with, “oh that,” but didn’t answer my question.  She attempted to move the conversation away, but I pressed her with more questions, “no really, what happened to you?”  She dismissively waved her hand, and said, “Look … I was raped by a few guys a couple nights ago.”

What???  I was so horrified I could barely speak.  A few guys?  How utterly revolting.  I didn’t know bigstock-Woman-Depressed--Black-and-wh-27250094what to say.

It was clear she did not want to talk about this.  I could tell by the way she was steering me from conversation about this gang rape that there was no way she had reported it to the police.  Her demeanor revealed that she didn’t even take it in as a violation worthy of reporting.   Her use of the word “few” was such an incongruous diminution of the experience.   Nonetheless I sputtered around and asked if she had reported it, or if she had gotten herself to a hospital or … anything.  She said, “oh honey … that’s my rent.  It happens a few times a month.  It’s my rent, that’s all.”  As if she were trying to console me.

So I guess that is how people manage to live with no money.  For years and years and years.

It is difficult for me to give the national average for the length of time it takes for a worthy claimant to go through the disability appeals process – there is a good deal of variability.

Among my clients, they would typically apply, and receive a denial within about three to six months.  A claimant has sixty days to file an appeal.  The next level of appeal in most states is to “Reconsideration.”

I practice in Missouri, a state that does not have the reconsideration level of appeal, so I’m a bit fuzzy on how long reconsideration takes in the states that do have it.  But, in Illinois, where a few of my clients live, they do have reconsideration, and the claims were processed within about another six months give or take.  Assuming a denial (and all of my clients were denied at the reconsideration phase), the next appeal is to the “Office of Disability Adjudication and Review,” where the Administrative Law Judges mostly are.

The wait for a hearing date to be scheduled at the Office of Disability Adjudication and Review is in the range of a year and a half to two years, at least in my neck of the woods.

Then, once you have the hearing – and let’s (for the sake of brevity) assume you do not have to have one or two “supplemental” hearings … you will have to wait another two months or so for the written decision to be generated.

So … if you were to have received a favorable decision by the time you had gone before an Administrative Law Judge you would already have lived without income for … somewhere around three and a half years.  That’s a fairly optimistic time line, though.

And, there are two more layers of appeal past the Office of Adjudication and Review – to the “Appeals Council” and to federal court.

Be aware that sometimes the appeals process is not a linear track.  For example, you can be denied by an Administrative Law Judge, appeal to the Appeals Council (where your case will be for about two years pending a decision), and have it sent back to the same Administrative Law Judge who denied you before, where you will wait in the queue again at the Office of Disability Adjudication and Review to get a new court date.  Then, you will have the hearing with the same judge who denied you before, and wait the two-ish months for your decision, find out you lost again, and then appeal again to the Appeals Council … wait some more … and maybe have the case sent back to an Administrative Law Judge again.  I have heard tell of cases sent back as many as three times from the Appeals Council back to the judge to do it again.

If the Appeals Council does not send the case back, but instead denies it, you can appeal to federal court … where you will wait and wait and wait some more.

During that time … how do you pay the rent?

To follow-up on the homeless client who paid her rent by being raped … she had such a hard time proving her disability.  Though she was so ill, she had such a difficult time under her circumstances making it to her doctors’ appointments.  She routinely missed them.  And when she did go, her personality was such that she would not divulge much about her symptoms, she did not go to her docs with a tidy list of her complaints and concerns as I might do.  Her doctors didn’t have the time to pull information from her.  So, medical documentation of her impairments was … weak.

Because she would not report her many, many gang rapes to the police or to her doctors … there was no way to get this information into evidence before the Administrative Law Judge, except by asking her in a hearing … and there was no point to that.

But, legally, the rapes were quite besides the point.  Being a victim of crime doesn’t make you disabled.  Having a seriously hard-luck story does not make you disabled.  But, at any rate, the judge never even knew.  And I wished he had, at least so he could hurry up his decision – whichever way it was going to go – because the quicker we could get this lady a safe place to stay, the better.  Unfortunately, this particular judge is a plodding sort who takes his time making sure all the t’s are crossed and all the i’s are dotted ….bigstock-Movie-ending-screen--Vector-E-38593006

So for her anyway the fairy tale might go something like … once upon a time there was such a good and worthy woman with very major health issues, who waited and waited and waited for her disability, but it never came … and she died on the street.    The end.

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