published Monday, September 16th, 2013

Inside the world of disability claims

 Disability Judges
Disability Judges

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    North Chattanooga resident Becky Wellingsford sits in the Mean Mug coffeeshop and speaks about how she has tried for more than two years to be approved for Social Security disability benefits.
    Photo by Dan Henry.
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Should Social Security disability be harder to get?

A congressional panel that earlier this year criticized judges for lavishly awarding Social Security disability benefits might have been talking about Tennessee.

It depends how you crunch the numbers.

Nearly two-thirds of administrative law judges in Tennessee grant benefits to more than half the sick and injured workers who come before them, federal figures show.

In June, members of the U.S. House Oversight and Government Reform Committee released a letter slamming judges who grant benefits in more than 50 percent of their cases. Rep. James Lankford, R-Okla., called it a "very, very high rate" of approval for claims that already had been turned down twice in local hearings.

But there's another way to look at it, a local disability attorney said: Judges are the back-up for a high turn-down rate at the first stage of the application process.

Though the disability rate among Tennessee workers is about a third higher than the national average, the state has the second-lowest rate in the nation for initial approval of disability claims, figures from the Social Security Administration show.

In 2012, just 25.7 percent of sick or injured Tennessee workers were granted Social Security disability on initial application. That's compared to 54.7 percent in the state with the highest rate, Wyoming. Those figures don't count other forms of disability awards, for the elderly or children, for example.

People who are turned down initially can ask for reconsideration. If they're denied again, going before an administrative law judge is the third step.

What that means, local disability attorney Peter Murphy said, is "more people are making it to the hearing level."

By comparison, nearly two-thirds of Georgia judges and just more than half of Alabama judges awarded benefits in fewer than 50 percent of the cases they heard.

"There's so many factors" affecting decisions to grant or withhold disability benefits, said Murphy, of McCarthy, Murphy and Preslar. "Some of the gross generalizations I've seen some critics of the disability system run up the flagpole are very easy to poke holes in. ... Disability is not a good living."

A local woman who has tried for almost three years to get benefits after disc disease and spinal stenosis ended her career said fat-cat congressmen who imply people on disability are soaking taxpayers don't know what it's like to be sick and desperate.

"I'd like for them to live a day in my shoes, with no income coming in ... no way to pay for medicine and food," said former bookkeeper Becky Wallingsford. "They don't have a clue what we go through."

Complex cases

Three House Oversight and Government Reform Committee members wrote the Social Security Administration earlier this year denouncing high approval rates for disability benefits by administrative law judges. The panel's chairman is Rep. Darrell Issa, R-Calif., a spending hawk.

Social Security officials and others have said the retirement and income security program's finances are unsustainable and that without reform, the program will run out of money by 2016. Federal figures show claims for disability benefits have grown 25 percent since 2007, and the program paid out $135 billion in benefits in 2012. The Government Accountability Office reported last week that 36,000 workers got as much as $1.3 billion in undeserved benefits between December 2010 and January 2013.

The House group's letter to Social Security said that of 1,560 judges who had decided at least 50 cases between October and March, 195 judges awarded benefits in at least 75 percent of cases, according to The Associated Press.

Not many of those generous judges are in Tennessee, Alabama or Georgia, according to figures from DisabilityJudges.com, a website that compiles monthly statistics from Social Security administrative law judges.

Of Tennessee's 67 such judges, three -- two in Kingsport and one in Nashville -- hit the 75 percent mark in 2012. None of Georgia's 66 judges hit the mark, and only one of Alabama's 56 judges did.

Demographics, in the form of the aging wave of baby boomers; eased eligibility standards; and a slow economy are factors in the rising number of claims.

Murphy said disability cases are enormously complex and varied.

A sick or injured worker's case might be weighed on factors such as age, work background, education level and health.

A 50-year-old lineman with a disc injury might be more likely than a 30-year-old computer programmer with the same injury to be declared disabled because of his job's physical demands, he said. And high disability rates correspond with poorer, less-educated, less-healthy states, including most of the South.

The workload is heavy. The 12 judges in the Chattanooga office dispose of an average of 2.4 cases per day, and it takes about 14 months to get a hearing, according to DisabilityJudges.com. That's after the months it takes to get through the initial denial and reconsideration.

Murphy said the hearing delay is up from about eight months because the Chattanooga judges, who he said are very efficient, were handed stacks of cases from other jurisdictions in an attempt to cut down on backlogs elsewhere.

"The judges are doing their absolute best do get the right results. They're trained to do that," Murphy said. "I think most of the time the system works [but] there are going to be occasions when, in my opinion, the humanity of the system causes someone to be not helped when they should be."

Last chance

Wallingsford, 57, said her life crumbled in January 2011 with a crisis in her spinal disorders and two surgeries a few months after she lost her job and her insurance.

Her savings lasted about 18 months, she said. Her house is paid for but she depends on her 80-year-old mother to pay her utilities.

"She's on a fixed income. ... I don't want to drain her dry. I feel so bad that I'm having to take from her," Wallingsford said.

As a single, childless woman, "I'm not eligible for TennCare. I'm not eligible for Medicaid. I'm not eligible for anything."

She said Erlanger filed her initial claim two and a half years ago and she's gotten some medical help through Project Access, which helps people who can't pay.

After more than 30 years in the workforce, she said she can't figure out what kind of job she could do.

She lives with constant back pain from damage in the cervical and lumbar spine. She walks with a cane because of nerve damage in her leg. She used to type 75 words a minute but now her hands are so numb she can't feel the keys.

Turned down for Social Security disability on initial application and reconsideration, she hired an attorney. The first administrative law judge turned her down, too, she said.

"I was shocked when I got the denial letter," she said. Then she discovered that her attorneys hadn't provided a complete file of her medical records for the hearing. She hopes to hear within a month whether she'll get another court date.

If she's turned down again, she has the option of filing a new claim and starting all over. But the prospect chills her.

"We're talking about two and a half more years. I can't do it."

Wallingsford said a while back, she was talking despairingly with a clerk in the disability claims office in Nashville.

"I asked, 'What do people do?' She said, 'They either wind up getting a job, or they die.'"

Contact staff writer Judy Walton at jwalton@timesfreepress.com or 423-757-6416.

about Judy Walton...

Judy Walton has worked 25 years at the Chattanooga Times and the Times Free Press as an editor and reporter focusing on government coverage and investigations. At various times she has been an assistant metro editor, region reporter and editor, county government reporter, government-beat team leader, features editor and page designer. Originally from California, Walton was brought up in a military family and attended a dozen schools across the country. She earned a journalism degree ...

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