Social Security Disability payouts have risen drastically since the start of the recession. Over the last six years, claims have increased by 25 percent, and 3.2 million Americans have applied for the either Social Security Disability or Supplemental Social Security Income in 2012 alone. Along with the dramatic increase in claims and payouts, budget cuts have also created a backlog of more than a million overdue follow-up reviews for current recipients.
Some House of Representatives officials believe the large number of approvals is due to hasty or even activist judicial decisions, which typically occur during the second appeal in the application process. To reduce the appeals backlog, administrative judges are required to decide 500 or more cases per year, which may ultimately cause them to award more benefits than they would if they had more time to consider each case.
Other officials said the increasing payouts may have more to do with the uncertain nature of the most common disability claims including bone pain, muscle pain and mental disorders. “Pain cases and mental cases are extremely difficult because–and even more so with mental cases—there’s no objective medical evidence,” said Randall Frye, a Social Security administrative law judge, in a CBS news interview.
Still, some Social Security experts said there is a more benign explanation for the increases in claims and payouts. “I think the whole situation is overblown, quite frankly, and that the claims are up for a lot of different reasons,” said Paul Pochepan, a Social Security and bankruptcy attorney in Buffalo, New York. “The economy has kept people working who probably shouldn’t have been working, and they become eligible given the SSA’s disability standards.”
Workers with physical jobs have had to postpone retirement, and many have lost the disability-related benefits and accommodations their employers used to provide. With few skills to transfer to white-collar, more disability-friendly workplaces, they’re often left with little choice but to apply, he said.
Foul play may not have anything to do with the lack of follow-up reviews, either. “The follow-ups have always been a very random thing in my opinion,” said Pochepan, who has spent more 20 years helping people apply for disability benefits. “Because there are so many more people on the rolls, the SSA just can’t really keep up with it.” It might be wise for the SSA to follow up more often with younger enrollees, but they constitute only a small minority of the total recipient population, he said.
While claims and payouts have certainly increased by a large margin, denial rates have also risen over the last several years, and it’s tougher than ever for truly disabled workers to get the money they need, some experts said. The primary requirement for the program is a medical condition that will make work impossible for 12 months or longer, and applicants must have medical documentation and proof of prior of treatment.
“Clients may have been hospitalized,” said Pochepan, “but if they can’t regularly see a doctor, they might not qualify.” Of course, visiting a doctor can be difficult or impossible for people who are disabled, out of work and without health insurance.
For those who can’t afford to pay out of pocket, Medicaid may be a viable option. Once they’re receiving ongoing care from a Medicaid-approved physician, it becomes much more feasible to produce the required documentation for Social Security disability benefits. Depending on a worker’s location and specific condition, free or low-cost clinics may also provide the necessary treatments and proof.
The length of the application process can also take its toll. Most cases take between 12 and 18 months to resolve, during which time applicants may lose the ability to pay for ongoing care. Pochepan said that some of his clients take advantage of COBRA benefits as soon as they become disabled, and that that coverage will sometimes last for the duration of the application process. Still, the best way to hasten the process and avoid unmanageable expenses is to work with an attorney or financial advisor experienced in obtaining disability benefits, he said.
Fortunately, disability income can’t negatively impact Social Security retirement benefits, even for people who enroll in the program years before they retire. “Once a client starts to receive disability, it’s actually the equivalent of their full retirement benefits,” said Pochepan.
In fact, people who collect before age 66 while they are still working may be able to qualify for their full benefits if they become disabled during that time, he said. Like retirement benefits, disability income is also subject to the cost of living adjustment, so recipients can count on yearly increases based on inflation and price fluctuations.
Clients’ retirement accounts and private benefits packages won’t affect their disability benefits, either. “Disability benefits just turns into retirement benefits once they reach their full retirement age,” said Pochepan. They are determined entirely by earnings history, and while additional income may change recipients’ tax liabilities, it won’t eat into their monthly checks.
In the long run, however, people may not be able to depend on Social Security to provide significant help if they become disabled before retirement. Trustees predict that the Social Security disability fund will dry up by 2016 if Congress doesn’t take action, and denial rates continue to climb. “There will be a greater strain on the system, whether the claims are fraudulent or not,” Pochepan said. Just like soon-to-be retirees, people with the greatest disability risks should save as much as possible to protect their living standards in decades to come.