Statement of Linda Fullerton, Social Security Disability Coalition, Rochester, New York

Our group and experiences, are a very accurate reflection and microcosm of what is happening to millions of Social Security Disability applicants all over this nation.  The current Social Security Disability program and the process that an applicant endures when filing for disability benefits, causes irreparable harm and has many serious side effects including unbearable stress, depression, and in some cases the depression is so severe that suicide seems to be the only option to get rid of the pain, of dealing with a system riddled with abuses against the disabled, already fragile citizens of this country.  According to past GAO reports, the SSD system is at HIGH RISK but Congress keeps ignoring the problem. 

The Social Security Disability New Approach Program is a welcome change from what we have seen in decades past.  Everyone that I have dealt with there has been very courteous and responsive to our concerns and I am very grateful for that.  We keep in constant communication with them as much as we are allowed to participate.  But from what I can see the proposals that are being suggested so far, by the Disability New Approach Program, will not do very much to relieve this horrendous situation in the very near future.  While they are doing their very best with the resources they have, they cannot do it alone, as many things needed to truly reform this system, must be legislated by Congress.  In addition we ask that in future Congressional hearings, members of the Social Security Disability Coalition be allowed to actively participate instead of being forced to always submit testimony in writing, after the main hearing takes place.  We are willing to testify in person before Congress and we should be permitted to do so.  We want a major role in the Social Security Disability reformation process, since any changes that occur have a direct major impact on our lives and well being. 

The time it takes to process a Social Security Disability claim from the original filing date is now, in many cases, at least 1-3 years or longer.  If claimants provide sufficient medical documents when they originally file for benefits they shouldn’t be denied at the initial stage, have to hire lawyers, wait years for hearings, go before administrative law judges and be treated like criminals on trial.The current SSD process seems to be structured in a way to be as difficult as possible in order to suck the life out of applicants in hope that they give up or die in the process, so that Social Security doesn't have to pay them their benefits.  To a population that is already compromised, this is unacceptable and this issue must be made a priority for every member of Congress since it is a life and death situation for millions.  Many SSD applicants are losing EVERYTHING in the process of applying for benefits, their homes, all their financial resources, their healthcare and worse yet their lives. 

The current claims process is also set up to line the pockets of the legal system, since you are encouraged from the minute you apply to get a lawyer.  Why should you need to pay a lawyer to get benefits that you have paid into all your working life?  The SSD program  is structured so that it is in a lawyer’s best interest for your case to drag on since they automatically get paid a percentage of a claimant’s retro pay – the longer it takes the more they get even if they do almost nothing. From the horror stories I hear from claimants many attorneys are definitely taking advantage of that situation.  The stress and worry that applicants are forced to endure while applying for SSD benefits causes further irreparable damage to their already compromised health and is totally unacceptable.  Many lose everything, and now in addition, are also forced into a level of poverty on top of their illnesses, which they will have to live with the rest of their lives since they can no longer earn a living.  Due to the devastation on their lives and health, the Ticket to Work program, and any chance of possibly getting well enough to return to the work force, even on a part time basis, is now out of the question. 

The SSA Customer service is extremely poor and in major need of improvement across the board.  If any corporation in this country did business like the SSA, the majority of employees would be fired on the spot, and the company would be shut down within a year.  Here is just a small sampling of the constant complaints we receive about the Social Security Disability system and its employees:

Extraordinary wait times between the different phases of the disability claims process

Employees being rude/insensitive to claimants

Employees outright refusing to provide information to claimants or do not have the knowledge to do so

Employees not returning calls

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 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

Complaints of lack of attention or totally ignoring  - medical records provided and claimants concerns by Field Officers, IME doctors and ALJ’s. 

Fraud on the part of DDS/OHA offices, ALJ’s, IME’s – purposely manipulating/ignoring information provided to deny claims.

Complaints of lost files and files being purposely thrown in the trash

Complaints of having other claimants information improperly filed/mixed in where it doesn’t belong causing breach of security

Poor/little coordination of information between the different departments and phases of the disability process

These complaints refer to all phases of the SSD process including local office, Disability Determinations, Office of Hearings and Appeals and the Social Security main office in MD (800 number).

SOCIAL SECURITY DISABILITY COALITION – SSD SYSTEM REFORM GOALS

We want to have claimants who have actually gone through the SSD system themselves to be part of a group who actually participates in the Social Security Disability New Approach program and which has major input and influence on the decision making process before any final decisions/changes/laws are instituted by the SSA Commissioner or members of Congress.  This is absolutely necessary, since nobody knows better about the flaws in the system and possible solutions to the problems, then those who are forced to go through it and deal with the consequences when it does not function properly. 

We want disability benefits determinations to be based solely on the physical or mental disability of the applicant.  Neither age, education or any other factors should ever be considered when evaluating whether or not a person is disabled.  If a person cannot work due to their medical conditions – they CAN’T work no matter what their age, or how many degrees they have.  This is blatant discrimination, and yet this is a standard practice when deciding Social Security Disability determinations and should be considered a violation of our Constitution.  This practice should be addressed and eliminated immediately.

All SSD case decisions must be determined within three months of original filing date.  When it is impossible to do so a maximum of six months will be allowed for appeals, hearings etc – NO EXCEPTIONS.  Failure to do so on the part of SSD will constitute a fine of $500 per week for every week over the six month period - payable to claimant in addition to their awarded benefit payments and due immediately along with their retro pay upon approval of their claim.  SSD will also be held financially responsible for people who lose property, automobiles, IRA’s, pension funds, who incur a compromised credit rating or lose their health insurance as a result of any delay in processing of their claim, which may occur during or after (if there is failure to fully process claim within six months) the initial six month allotted processing period .

Waiting period for initial payment of benefits should be reduced to two weeks after first date of filing instead of the current five month waiting period.

Prime rate bank interest should be paid on all retro payments from first date of filing due to claimants as they are losing it while waiting for their benefits to be approved.

Immediate eligibility for Medicare/Medicaid upon disability approval with NO waiting period instead of the current 2 years.

SSD required medical exams should only be performed by board certified independent doctors who are specialists in the disease that claimant has (example – Rheumatologists for autoimmune disorders, Psychologists and Psychiatrists for mental disorders).  Independent medical exams requested by Social Security must only be required to be performed by doctors who are located within a 15 mile radius of a claimants residence.  If that is not possible – Social Security must provide for transportation or travel expenses incurred for this travel by the claimant. 

Too much weight at the initial time of filing, is put on the independent medical examiner’s and SS caseworker’s opinion of a claim.  The independent medical examiner only sees you for a few minutes and has no idea how a patient’s medical problems affect their lives after only a brief visit with them.  The caseworker at the DDS office never sees a claimant.  The decisions should be based with much more weight on the claimant’s own treating physicians opinions and medical records.  In cases where SSD required medical exams are necessary, they should only be performed by board certified independent doctors who are specialists in the disabling condition that a claimant has (example – Rheumatologists for autoimmune disorders, Psychologists and Psychiatrists for mental disorders).  Currently this is often not the case.

All Americans should be entitled to easy access (unless it could be proven that it is detrimental to their health) and be given FREE copies of their medical records including doctor’s notes at all times.  This is crucial information for all citizens to have to ensure that they are receiving proper healthcare and a major factor when a person applies for Social Security Disability.

ALL doctors should be required by law, before they receive their medical license, and made a part of their continuing education program to keep their license, to attend seminars provided free of charge by the SSA, in proper procedures for writing medical reports and filling out forms for Social Security Disability and SSD claimants.

More Federal funding is necessary to create a universal network between Social Security, SSD/SSI and all outlets that handle these cases so that claimant’s info is easily available to caseworkers handling claims no matter what level/stage they are at in the system.  All SSA forms and reports should be made available online for claimants, medical professionals, SSD caseworkers and attorneys, and be uniform throughout the system.  One universal form should be used by claimants, doctors, attorneys and SSD caseworkers, which will save time, create ease in tracking status, updating info and reduce duplication of paperwork.  Forms should be revised to be more comprehensive for evaluating a claimant’s disability and better coordinated with the SS Doctor’s Bluebook Listing of Impairments. 

Institute a lost records fine – if Social Security loses a claimants records/files an immediate $1000 fine must be paid to claimant. 

Review of records by claimant should be available at any time during all stages of the SSD determination process.  Before a denial is issued at any stage, the applicant should be contacted as to ALL the sources being used to make the judgment.  It must be accompanied by a detailed report as to why a denial might be imminent, who made the determination and a phone number or address where they could be contacted.  In case info is missing or they were given inaccurate information the applicant can provide the corrected or missing information before a determination is made.  This would eliminate many cases from having to advance to the hearing and appeals phase.

The SSA “Bluebook” listing of diseases that qualify a person for disability should be updated more

frequently to include newly discovered crippling diseases such as the many autoimmune disorders

that are ravaging our citizens.  SSD's current 3 year earnings window calculation method fails

to recognize slowly progressive conditions which force people to gradually work/earn less for periods

longer than 3 years, thus those with such conditions never receive their 'healthy' earnings peak rate.

A majority of SSD claimants are forced to file for welfare, food stamps and Medicaid, another horrendous process, after they have lost everything due to the inadequacies in the Social Security Disability offices and huge claims processing backlog.  If a healthy person files for Social Service programs and then gets a job, they do not have to reimburse the state once they find a job, for the funds they were given while looking for work - why are disabled people being discriminated against?  Claimants who file for Social Service programs while waiting to get SSD benefits, in many states have to pay back the state out of their meager SSD/SSI benefits once approved, which in most cases keeps them below the poverty level and forces them to continue to use state funded services.  They are almost never able to better themselves and now have to rely on two funded programs instead of just one.  This practice should be eliminated.  In all states there should be immediate approval for social services (food stamps, cash assistance, medical assistance, etc) benefits for SSD claimants that does not have to be paid back out of their SSD benefits once approved.

The claims process should be set up so there is no need whatsoever for claimant paid legal representation when filing for benefits and very little need for cases to advance to the hearing and appeal stage since that is where the major backlog and wait time exists. The need of lawyers/reps to navigate the system and file claims, and the high SSD cap on a lawyer's retro commission is also a disincentive to expeditious claim processing, since purposely delaying the claims process will cause the cap to max out - more money to the lawyer/rep for dragging their feet adding another cost burden to claimants.  Instead, SS should provide claimants with a listing in every state, of FREE Social Security Disability advocates/reps when a claim is originally filed in case their services may be needed.

Audio and/or videotaping of Social Security Disability ALJ hearings and during IME exams allowed at all times to avoid improper conduct by judges and doctors.  A copy of court transcript should automatically be provided to claimant or their representative within one month of hearing date FREE of charge.

Strict code of conduct for Administrative Law Judges in determining cases and in the courtroom.  Fines to be imposed for inappropriate conduct towards claimants.

We have heard that there is a proposal to give SSD recipients a limited amount of time to collect their benefits. We are very concerned with the changes that could take place.  Since every patient is different and their disabilities are as well, this type of “cookie cutter” approach is out of the question.  We especially feel that people with psychological injuries or illness would be a target for this type of action.  Some medical plans pay 80% for treatment of biological mental heath conditions, but currently Medicare only pays 50% for an appointment with a psychiatrist.  This often prohibits patients from getting proper treatment and comply with rules for continual care on disability.  The current disability review process in itself is very detrimental to a patient’s health.  Many people suffer from chronic conditions that have NO cures and over time these diseases grow progressively worse with no hope of recovery or returning to the work force.  The threat of possible benefits cut off, and stress of a review by Social Security again is very detrimental to a recipients health.  This factor needs to be taken into consideration when reforming the CDR process. 

NOTE: The problems with the Federal Social Security Disability program cause an extra burden on state Social Service programs, which could be greatly reduced once this Federal program is fixed, and the states along with the claimants would reap the benefits in the long run.  State politicians need to put pressure on congress to put more funds into the SS system to hire more qualified claim examiners and better educate employees, doctors and the claimants themselves to speed up the process. 

In closing, most of us were once hard working, tax paying citizens with hopes and “American dreams” but due to an unfortunate accident or illness, have become disabled to a point where we can no longer work.  Does that mean we are not valuable to our country, or give the government and politicians the right to ignore or even abuse us?  Due to circumstances beyond our control, and on top of our disabilities, we now live the American nightmare with no hope of relief in sight! Contrary to popular opinion, nobody willingly chooses this type of existence.  Politicians are supposed to work FOR us not ignore us.  Anyone reading this, could suddenly find themselves dealing with these issues in the future, and we are holding you accountable to fix these problems now! Nobody thinks this horrible existence could ever happen to them, but there are millions of Americans who are suffering and dying due to this negligence, and our lives depend on your cleaning up this mess immediately!  Currently we are considered "disposable" people by general and government standards, so our cries and screams are ignored, they would prefer that we just shut up or die.  I am here to tell you those days are over now.  We are watching, we are waiting, we are disabled and we vote!