Federal disability benefits system set for overhaul

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Federal disability benefits system set for overhaul

[source: http://chronicfatigue.about.com/b/a/2004_01_13.htm ]

January 13, 2004

WASHINGTON - Cerio of Waverly, N.Y., applied for disability benefits

in

September after being kept from work for more than a year by incessant pain

from fibromyalgia, an affliction of the joints and muscles.

Her disability claim has been denied once, and Cerio has been told it might

take a year for her appeals to wind through the benefits process. " I am

really

stressing about what's going to happen, " she said. " If it takes a year, how

am

I going to live? I don't know. "

Each year, Social Security appeals judges grant disability benefits to about

250,000 people who have been turned down repeatedly and have generally been

waiting more than two years for the cash payments and health insurance the

government provides to people too disabled to work.

This month the Social Security Administration is launching what officials

say

will be a drastic overhaul of the nation's disability insurance program,

streamlining a painfully slow process that is a minefield of disputes and

delays.

" This is about a process that simply doesn't work, " Jo Anne Barnhart, who

heads

the Social Security Administration, said in an interview. " When you look at

the

system that we have today, what you see is a system that takes a very long

time

to get through. "

Of the 2.5 million Americans who apply for disability benefits each year,

thousands end up waiting years for approval. In the meantime, they survive

on

their savings, state assistance programs and the aid of friends and family.

Barnhart's proposed reforms include everything from electronic forms to

medical

experts to speed the process for the severely disabled. Though nearly

everyone

agrees the system needs an overhaul, however, some question whether

Barnhart's

plan would help.

" If it happens, everyone will be amazed, " said Schnaufer, an attorney

in

ton, Ill., who helps applicants appeal rejections. " The SSA has

historically had great difficulty with any kind of technological change.

Right

now the Office of Hearings and Appeals has difficulty using a two-hole

punch. "

Ken Apfel, who headed the Social Security Administration from 1997 to 2001,

is

only slightly more optimistic. " We grappled with some of these issues and

found

that we were not able to pull it off, " said Apfel, adding that during his

tenure the agency gave up on an automation plan because it couldn't get

states

to adopt it.

But Barnhart insists she can make the changes work, in part because the

system

is so obviously broken.

" One of the things that will make it possible to make change is that

everybody

is committed to change, " she said.

Few dispute that the system badly needs improving.

A disabled person's application is reviewed first by a state agency. If it

is

denied, a complex appeals process ensues, ultimately ending in federal

court.

According to the SSA's analysis, more than 10,000 people each year appeal

their

cases to federal court - usually three or four years after their initial

application - and more than 6,000 of these cases are sent back to the agency

for reconsideration, meaning they are often granted.

" For some people it takes two or three years to get through the process, "

said

Eileen Sweeney, of the Center on Budget and Policy Priorities, a Washington

think tank. In some cases, she said, a person's disability worsens until

they

become so sick that they are granted benefits.

The Social Security system has not always been dysfunctional. Saddled with

antiquated paperwork, the system has become overwhelmed with a rising tide

of

applicants and a confusion of rules written and rewritten over the years.

Courts have meanwhile imposed new procedural requirements, and medical

advances

have prompted new definitions of disability, which state and federal

officials

have had to absorb and implement.

Barnhart is offering reforms she said would empower officials to make

decisions

earlier. For example, units of medical experts would advise decision-makers

throughout the process, providing faster service for those who are

" obviously

significantly disabled. "

The reforms also include allowing a federal attorney to intervene earlier

when

an application has been denied by a state.

In addition, the multiyear reform plan relies heavily on an electronic

application form being tested in Illinois, California and North Carolina

that

is to be rolled out nationwide beginning this month.

Each application requires documentation - work histories, medical records

and

so on - that can stretch to hundreds of pages. Currently, whenever a new

agency

reviews the file, all the paperwork has to be packed up and sent over.

Barnhart said this causes much of the delay. Using electronic files would

allow

instantaneous document transmission and make it far easier to track

documents,

she said.

But it is an enormous task to overhaul the recordkeeping of an agency with

more

than 2 million disability applicants a year. SSA officials say the new

electronic system will cost about $890 million to install over the next

decade,

although they also contend it will save $1.3 billion at the same time.

By Singer Chicago Tribune

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