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Suddenly disabled, unable to work and need benefits? Prepare for financial ruin first

Jeff Caplan, Fort Worth Star-Telegram on

Published in Home and Consumer News

FORT WORTH, Texas -- Coming to grips with never again being able to work because of a debilitating disease on injury can gnaw at one's self-worth.

But 51-year-old John Tovar of Arlington never expected his spiral into full-on depression would come as a result of waiting ... and waiting ... and waiting ... just for the opportunity to state his case to qualify for Social Security disability benefits.

In Fort Worth, and across the nation, the system is backlogged to the point of near-absurdity. Local applicants can wait up to two years for a hearing before a judge, with many cities facing longer waits. A hearing is scheduled after applicants have already been denied -- as most typically initially are -- a process in itself that can take up to eight months.

And so as the bureaucratic clock creeps toward a hearing, many applicants are faced, month after month, with slashed household income, dwindling or drained savings accounts and often no option left but to pile car payments, mortgage payments, the electricity bill and prescriptions and groceries on to credit cards.

"Filing for disability was a last resort for me," said Tovar, who suffers from diabetes, nerve damage and carpal tunnel syndrome. "That's really one of the main reasons I did this because we've been a two-income family for the longest time, and now my wife is the only one working. It makes me feel pretty worthless. What kind of took me aback was when they finally set up the final hearing, they said it would be anywhere from 12 to 18 months.

"Why would it be 12 to 18 months?"

The short answer is a lack of appropriate funding of Social Security by Congress.

"It's just a lack of staff and it's tied directly to a lack of appropriations," said prominent disability attorney Charles Hall, whose law firm is based in Raleigh, N.C. "And it may get worse in the course of next year depending on what happens with appropriations in the budget office."

Social Security offices nationwide, including the downtown Fort Worth location, are understaffed and underfunded to handle the carousel of thousands of cases submitted each year. In Fort Worth, 10 administrative law judges are tasked with 5,899 pending disability cases, according to figures compiled by the Social Security Administration.

The average wait in Fort Worth for a hearing is 483 business days, or nearly two years. While it seems excessive, it's actually one of the speedier rates in the state and country. San Antonio's average wait is 527 days; downtown Dallas is 544; the Rio Grade Valley is a whopping 622 days. Applicants in Miami wait for a hearing on average 759 days, or close to three years.

More than 1 million Americans are awaiting a hearing with an average wait of two years.

"In the last couple of years, we've seen applications decline, yet the backlog went from unacceptable to extremely unacceptable," said Mike Stein of Allsup, which represents people attempting to qualify for disability benefits. "I say that as an advocate of people simply asking for a yes or no from the government. Citizens should have some money in the bank for a rainy day. But when you get to the hearing level, who has that kind of rainy day fund?"

Rep. Sam Johnson, R-Texas, a member of the House Ways and Means Committee where he serves as the chairman of the Social Security Subcommittee and sits on the Health Subcommittee, said the status quo is "unacceptable."

Since becoming chairman, Johnson has held 18 hearings on the disability benefits program, including as recently as Sept. 6. In February, Johnson called on President Donald Trump to nominate a Social Security Commissioner, a position that remains unfilled.

"To make matters worse, these long wait times make getting back to work even harder for those who don't qualify for benefits. The status quo is unacceptable," Johnson said in a statement to the Star-Telegram. "That's why I recently held a hearing on this issue, where we discussed with the Social Security Administration what actions it's taking to address this issue and what obstacles it's facing.

"Social Security needs a Senate-confirmed Commissioner who can lead the agency and focus on providing the service Americans expect and deserve."

Tovar and his wife, Mina, have exhausted their rainy day fund, and then some.

Four years after nerve damage in his feet forced Tovar to leave his job at Poly-America in Grand Prairie -- where he worked for 20 years, and where his wife, Mina, 47, continues to work -- Tovar reluctantly applied for disability benefits in August 2016.

He just thought he'd surely eventually be able to return to work or find a job that didn't require him to be on his feet for hours a time. When the nerve damage spread to his hands and arms, Tovar lost all ability to work.

Tovar was denied disability benefits in July and requested a hearing in August. It could be two years before he gets that hearing.

 

Meanwhile, watching Mina wake up at 4:30 a.m. for work, then return to take care of the household, all on her salary of about $55,000, preys on his soul as much as the diabetes, neuropathy and carpal tunnel diminish his physical capabilities.

Along the way, he cashed in his 401(k) to pay off the remainder of the mortgage and clear credit card debt. But with only Mina's salary, rising medical and prescription costs are causing those credit card balances to balloon.

"He's a lucky one," said Hall. "All things considered, that's a very bad situation, but many are in worse situations."

Hall referenced a woman he represents who had a hearing Monday. Because of her predicament, she lives in a house with no electricity or functioning plumbing. Hardship cases are typically expedited. Even so, this woman was two years into her claim. She will likely wait another four to five months for a decision, and if she wins, another two to three months to receive her benefits.

Expedited hardship cases mean a longer wait for those like Tovar.

Some wait so long they die before their hearing. Last year, 7,400 people on wait lists were dead, according to a report by Social Security's inspector general.

Up to Congress

Disability benefits are not meant to replace salary, but rather to lend a helping hand. The average benefit is $1,037 a month. It won't help the Tovars pay down their credit cards again, but it could at least help them from piling on excessive debt.

"I've been thinking about that, too; what am I going to do if I get turned down?" Tovar said. "My condition is deteriorating. I'm just wondering what I'm going to do if it doesn't go through. Eighteen months from now, it's going to be worse."

Many claims that finally reach the hearing stage are declined. Of the 4,513 claims that went before a judge last fiscal year, 38 percent were denied.

A Fort Worth woman who has had breast cancer, has undergone heart surgery and suffers from chronic obstructive pulmonary disease that limits her lung functionality to 54 percent, filed her initial disability claim two years ago. She isn't scheduled for her hearing until early 2018.

She said she is "appalled at the process" and was too scared to be quoted by name for this story because she feared jeopardizing her chances at winning her claim, or delaying the process further. She said she has "has always worked and paid my taxes," but is now in "serious financial problems." If not for her ex-husband helping her pay bills, she said she would have lost her house through this process.

Making the system more efficient simply isn't in the cards until Congress chooses to appropriately fund Social Security so it can hire more administrative staff and judges.

"The problem is not enough funding from Congress. The local people work hard and work long days," said a Fort Worth disability attorney who asked not to use her name because she represents clients in front of the judges.

"The local office is trying to do what they can, but Social Security has always been that third wheel. Congress always finds reasons why they don't want to fund it."

(c)2017 Fort Worth Star-Telegram

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