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The source of this article is the Boston Globe: http://tinyurl.com/58rlx Reform talk passes disability program by By Michael Kranish, Globe Staff | February 14, 2005 CAVENDISH, Vt. -- Joe Allen had the classic New England dream: He quit his grueling job as traveling official with an electronics company, bought a country store in small-town Vermont, and aimed to live happily ever after. But when a blood disease made it impossible to work, he was advised to apply for Social Security disability payments. After all, he was told, he had paid Social Security taxes that are intended for just such emergencies. What Allen didn't know was that the federal system for approving disability payments is known for its inequities and inefficiencies. It took nearly two years and lengthy appeals before his application was approved. During that time, Allen, who became increasingly ill, lost his store and began to wonder whether the government was waiting for him to die before mailing a check. The payments ''saved my life, but I almost died trying to get it," said the 54-year-old Allen, a stout, bearded man who lives with his two dogs in the mountains near this small town. The disability program has received relatively little attention amid all the talk about overhauling its sister program, Social Security retirement. Yet the disability program is one of the largest in government, providing $71 billion in annual benefits to 7½ million people. A raft of government reports has concluded that delays in granting benefits are all too common, with the full appeals process taking nearly three years. ''The process still takes way too long," Martin H. Gerry, the federal official who oversees the disability system, said in an interview even as he touted overhauls that are underway. At the same time, government reports say fraud and waste are rampant in the disability program, including nearly $1 billion in overpayments last year. All of this may sound like just the kind of problem that President Bush and Congress are eager to tackle when they begin overhauling Social Security. But unless there is a dramatic shift, that will not happen. Bush has said he is focused only on the retirement portion of the program, which he wants to change by allowing private investment of some Social Security taxes. While White House officials acknowledge that the disability portion is plagued by problems, they said they hope that the problems can be fixed administratively. Overhauls first discussed nearly four years ago are only slowly being implemented, however. Only one state, for example, has instituted a switch from paper documents to computerized record keeping, with more to come this year, officials said. The 12.4 percent in Social Security taxes that workers and employers pay includes a 1.8 percent tax that goes to a fund strictly for disability payments -- a levy that many workers may not realize they are paying. While every employee who pays Social Security taxes is entitled to retirement benefits, only those who pass a series of exams are allowed to receive disability payments. The program has grown significantly as the baby boom population ages: About 7.5 million people receive the disability benefits, including 1.8 million dependents. The program's $71 billion per year cost is in addition to the $398 billion per year cost of retirement and survivor benefits. While the White House says Bush is not yet focusing on the disability program, some in the disabled community worry that benefit cuts will be applied to both the retirement and disability programs as a way to save money. For example, if the retirement plan benefits are cut by tying payments from the current system of wage indexing to price indexing, as some have proposed, it is unclear whether the same cut would be applied to disability benefits. In addition, Thomas Sutton, president of the National Organization of Social Security Claimants' Representatives, worries that Bush's plan for private Social Security accounts could hurt people with disabilities. He gave the example of a person who is disabled at age 37 and cannot return to work. That person would receive disability benefits but under the Bush plan would not be contributing to a private account. Upon retirement, that person would not have nearly as much money in a private account as a nondisabled person. ''Those of us who are advocates for the disabled are very concerned about the impact of privatization on the disabled and the survivors of the deceased, who are about one third of the people who receive Social Security benefits," Sutton said. If Bush is concerned about the retirement program being in crisis, he has cause to be even more alarmed about the disability system. The disability program is scheduled to start taking in less money than it pays out in 2008, compared to 2018 for the retirement program, officials said. The disability program will then start relying on its trust funds, which are slated to run out by 2029, and it might eventually draw on resources now spent on the retirement fund, potentially worsening the overall problem. But the biggest problem with the disability system, according to critics, is that it seems designed to be inequitable. While the disability program is run by the federal government, much of the decision-making authority is handed over to state-employed workers. That may explain why only 36 percent of initial claims are approved in Connecticut, close to the national average, compared to 60 percent of those who apply in New Hampshire. Medical reviews are performed by state bureaucrats, often based on evaluations done by private consultants whose expertise varies widely. A federal report said applicants are much more likely to get benefits in New England, which is overseen by the Boston office of the Social Security Administration, than in other parts of the country. ''The odds of being allowed benefits for claimants whose hearings took place in the Boston region were approximately two times higher than for claimants whose hearings took place in other regions," according to a 2004 report by the Government Accountability Office, a disparity that apparently has not received public notice until now. Social Security Administration officials acknowledge that decision-making can vary widely because some states do not have as many medical or vocational specialists as others. ''There is a very uneven distribution of expertise," said Gerry, the agency's deputy commissioner for disability and income security programs. He suggested the disparities may even out when the results of various appeals are taken into account, but his spokesman said later that data are ''not readily available" to prove that theory. To many people seeking benefits, the system can appear to be a maze that only a lawyer can penetrate. If a person is denied benefits during an initial review, there are four more steps that can be taken: an appeal to reconsider the denial; an appeal to an administrative law judge; an appeal to another review board; and, finally, a federal court suit. As a result, there is a thriving business of thousands of lawyers who file appeals and, if they win their case, are allowed to take 25 percent of the previously denied benefits. In the month of January 2005, lawyers received $68 million in such fees in 20,000 cases, according to a report by the Social Security Administration. Every year, about 2.5 million people file claims for disability benefits. Of those, 37 percent are initially approved. After appeals, the final approval rate climbs to 53 percent, according to Gerry. Gerry acknowledged that the system can be daunting, noting that the Social Security Administration employs 1,000 administrative law judges and holds 650,000 hearings a year, making the disability claims process ''the largest administrative law system in the world." Gerry said he is especially concerned that a poor person with disabilities who cannot afford a lawyer will not get benefits. ''I'm dissatisfied with where it is, and [Commissioner of Social Security Jo Anne B. Barnhart] is dissatisfied with where it is," Gerry said about the disability system. ''However, I'm satisfied we're making substantial progress to improve it, and we will try as quickly as possible to get it to where it should be." Once a person with disabilities receives benefits, which average $894 per month, few leave the system voluntarily. Only about one in 500 people on disability tell the Social Security Administration that they have improved enough to go back to regular working hours and conditions. Separately, 13,900 of 784,000 cases reviewed by the government in 2003 resulted in a cessation of benefits, a Social Security official said. Allen's case appears typical of those who experience delays in receiving payments. He did not know about the disability benefits when he went to town officials and asked for welfare assistance. ''It was the most humiliating thing I had ever done," Allen said. ''They said to apply for Social Security." Allen said his claim was denied his twice. Then, with the help of Vermont lawyer Judith Brownlow, he went before an administrative law judge. He said he wore shorts on the wintry day, enabling the judge to see that Allen's legs had bloated to 29 inches at the calf because of his medical condition. The judge overruled the initial denial. ''He was clearly someone who deserved the benefits," Brownlow said. © Copyright 2005 The New York Times Company ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn