A long, painful wait
Sunday, August 26, 2007
Nearly all American workers pay the federal government for insurance in case they get too sick to keep a job. But thousands of disabled workers wait longer for help in the Charlotte region than almost anywhere else in the nation.Many lose their homes, fall into bankruptcy or go without needed medicine awaiting Social Security disability payments. Some die before their cases are heard.
In one case, a Gastonia man took his own life.
David "Joey" McKee, 21, couldn't afford medicine to treat his manic depression and waited two years to learn whether he qualified for disability. In March, he jumped from an overpass into traffic on Interstate 85 near Kings Mountain.
"My son didn't have to die," said his mother, Lynn McKee. "The system failed him."
The disability program is supposed to provide a safety net for workers who become injured or mentally ill, but an Observer investigation found the system is flawed for a large swath of North Carolina because administrative law judges fail to issue enough rulings to keep pace with incoming cases.
The Carolinas have about 48,500 pending disability cases, including 8,704 in the Charlotte region. Waits at Charlotte's Disability Adjudication and Hearing Office rank among the longest nationwide, 125 out of 141 offices, a recent national report says.
Delays plague the nation's entire system. But applicants in the Charlotte area waited, on average, more than 20 months for disability benefits last year, about four months longer than workers nationally. At the same time, Charlotte judges decided fewer cases than their peers.
Charlotte judge Duncan Frye said judges in his office work "exceptionally hard" to reduce wait times but do not have enough support staff to collect applicants' medical records and prepare cases for hearings. Budget constraints have left the disability court with vacancies, said Frye, who is also executive vice president of the Association of Administrative Law Judges, which represents disability judges nationwide.
The nation's disability court system is suffering from vacancies, and the federal government says the Charlotte office employs 3.7 staff members per judge, compared with 4.2 nationally.
A panel that advises the president and Congress on Social Security authored a 2006 study that found judges, on average, issued 401 decisions the prior year. Despite thousands of pending cases, two Charlotte judges handed down fewer than 300 in 2006.
Social Security Administration Commissioner Michael Astrue testified to Congress in May that the agency asks judges to produce 500 to 600 decisions a year. He also testified that the agency wants to make some judges more productive.
He wields little authority to force change, however. By law, disability judges face no annual performance reviews and essentially can be removed only for corruption or misconduct. They are paid between $109,000 and $151,000 a year.
"They do whatever they want," said Linda Fullerton, president of the Social Security Disability Coalition, an advocacy group for applicants. "There is no oversight. They can run amok."
Extreme bottleneck
For the typical worker, the process is painstaking from the start.Employees seek help when illness strikes. They must produce extensive documentation of work and medical history, then wait up to five months for an answer.
Of the tens of thousands of claims filed in the Carolinas each year, about two-thirds are denied. Many appeal; their claims are again usually rejected.
Those who persist ask to appear before administrative law judges at local hearing offices.
That's when the longest wait starts. Years can pass before Charlotte judges issue a decision from their offices inside a four-story building on Carmel Road in south Charlotte.
Through interviews, documents and the results of a Freedom of Information Act request, the Observer found:
- Charlotte judges, on average, decided fewer cases than judges in other offices in the Carolinas: 375 cases per judge last year, compared with a combined average of 427 at offices in Greensboro, Raleigh, Columbia, Charleston and Greenville, S.C.
- At any given time, half of the six courtrooms at the Charlotte hearing office are not in use. The Observer spent about 40 hours monitoring the office this month.
The Observer repeatedly left messages for all the judges seeking comment. None agreed to speak publicly, saying they are prohibited from doing so.
Jamie Horwitz, a spokesman for the Association of Administrative Law Judges, defended the Charlotte judges' productivity. He gave explanations for their output but did not specify the judges' names.
Horwitz said two judges were assigned to spend 20 percent of their work hours hearing cases and 80 percent performing other duties. Some judges were assigned to Medicare cases, which he said are not counted as disability rulings.
In addition, he said Social Security assigned a third judge from the office to serve as a mentor to new judges, which prevented him from ruling on more cases, he said.
Another judge, Horwitz said, missed time from the bench to care for his wife, who died after a lengthy illness.
"Statistics are often misleading," Horwitz said.
Waits expected to worsen
In July, the average wait in Charlotte rose to 658 days, up 48 days from 2006.
With baby boomers reaching peak ages for disabling illnesses, the number of pending cases nationwide more than doubled to 738,000 between 2001 and 2007.
By 2010, some experts say, the figure will reach 1 million.
In Charlotte, complaints surfaced last year when Ronald McKoy, homeless and HIV positive, died as a resident of the Uptown Men's Shelter while waiting to find out whether he qualified for benefits.
Some homeless shelters said many of their beds are filled by people waiting for disability benefits. The payments -- which average about $947 a month -- could have helped McKoy and other applicants rent homes and obtain food and medicine, social workers said.
At a hearing this month, Robert Greathouse told a disability judge he lives on food stamps and the generosity of relatives. Once, he said, he lived in a homeless shelter because he could not work and had no income. Hearings are typically private, but a judge allowed an Observer reporter to watch, with the consent of Greathouse.
Greathouse, 45, said he used to install telephone systems for a living but applied for disability in January 2004 when it became too painful to work. He said he has had dizzy spells and trouble with his vision since he was bitten by a poisonous spider.
He now lives with relatives in Lincoln County and his mother pays his medical bills.
Greathouse said he isn't surprised by the long wait because acquaintances told him the process would take at least two years.
"I'm frustrated," he said. "I have a cyst on my spine. I have no ability to pay to have it treated."
After listening to testimony for more than 30 minutes, the judge told Greathouse he needed more time to make a decision. Saturday, Greathouse's lawyer said the judge awarded him benefits.
Courtrooms often empty
On a typical weekday, applicants from an area that spans the mountains near Asheville to as far east as Lumberton wait anxiously with attorneys to appear before a Charlotte judge.Sometimes, a handful of applicants and their friends and family fill part of the waiting room. Other times, the place is empty.
"You would think with all these backlogged cases, the place would be slammed with people," said Sharon Dye, who represents ailing workers.
Dye represented McKee, the Gastonia man who killed himself.
McKee tried to work as a retail stocker and store clerk but couldn't keep a job. Diagnosed as bipolar, border schizophrenic and learning disabled, McKee quit two jobs because he said he was depressed.
In 2004, McKee applied for disability to help pay for medicine to treat his mental illness. A psychologist's report says he was hearing voices and hallucinating.
He was turned down twice for disability. A March 2005 rejection letter says his condition was not "severe enough to be considered disabling."
But his family says he later slit his wrists and went to a hospital threatening to kill himself multiple times before he leaped from the Dixon School Road overpass onto Interstate 85. He was hit by a tractor trailer. Relatives said he was not taking his medication because he could not afford it.
After McKee's death, relatives said they attended his disability hearing in July and asked Judge Saul Nathanson whether McKee would have qualified for benefits.
"He said, `Absolutely. He should have gotten them a long time ago,' " McKee's sister, Misty Finnegan, said the judge told them. "We just want to know why it took so long."
Nathanson did not respond to messages.
Agency under fire
Social Security officials said turnover has affected the number of decisions judges issue. This year, the Charlotte hearing office has had one judge and four support staffers leave, the agency said in an e-mail response.
The office, which now has nine judges and 36 support staff members, is planning to hire seven new employees, the agency said.
Some experts say there is a simple explanation why some judges issue more decisions than others.
"We have some judges who are not that productive and should be made to be more productive," said Richard Warsinskey, president of the National Council of Social Security Management Associations, which represents 3,500 field office managers. "There should be some minimum accountability."
Lawmakers say the waits represent a large volume of the complaint calls they receive from constituents.
In March, U.S. Rep. Sue Myrick, R-N.C., of Charlotte, wrote a letter to Astrue, the Social Security commissioner. She said the wait times are unacceptable.
"The backlog in our area is reaching a crisis situation," the letter reads.
Astrue responded in writing a month later, saying that he was aware of the severe delays in North Carolina.
He blamed budget woes. Congress has appropriated the agency $700 million less than President Bush has requested in recent years, he noted. The result is the agency cannot afford to hire enough employees, he wrote.
To help speed the process in Charlotte, Social Security is holding some hearings by video teleconference. Applicants see an off-site judge on a screen.
Also, since fiscal year 2006, he said the agency has transferred more than 1,100 cases to other hearing offices.
Still waiting
Horace Duncan says the pain in his abdomen is so severe its feels like someone is sticking him with "sharp needles." Diagnosed with a carcinoid tumor, Duncan says he can no longer work as a small-engine repairman because he constantly vomits his meals, loses control of his bowels and can lift only 3 or 4 pounds at once.
Duncan, 54, of Belmont applied for disability benefits in 2005 because he had no income. He lives with his mother, who uses a wheelchair. They survive on her $558 monthly Social Security checks.
Although he has been hospitalized numerous times this year and had multiple surgeries, his disability application was rejected three times.
Duncan was waiting for a disability hearing when he received a letter in October from Social Security. A judge had dismissed his case, the letter said.
Social Security says Duncan did not file the necessary paperwork in time to receive a hearing. Duncan says the agency is at fault and he has re-applied.
Now Duncan is bracing himself, because he knows the process is slow.
"It's frustrating," Duncan said. "I need someone to help me."
Until that happens, he said, all he can do is wait.