13 WTHR - Indianapolis News |SOCIAL SECURITY DISABILITY

SOCIAL SECURITY DISABILITY

About the Series

Your peak earning years are supposed to mean buying a house, starting a family, setting money aside for college or retirement. But what if the unthinkable happens? If you become ill and can't work, will Social Security disability payments help cushion your fall? The Eyewitness News Investigators discovered your age may count against you when you're counting on the government to help you.

The story started with a viewer's tip that Social Security's screening process was taking too long and unfairly cutting off needy applicants. In fact, the Investigators found a nationwide backlog of appeals. As it turns out, many who appeal an initial denial do end up getting benefits - if they can wait that long. But as we learned, at least one ailing woman died before her case could be heard.

Dozens of e-mails and phone calls from viewers in response to the first piece yielded two more stories. The stories aired May 15, May 31 and August 1, 2001. They were reported by Richard Reeve, photographed and edited by Bill Ditton and produced by Kathleen Johnston and Gerry Lanosga.

Part One

For Ted Coar, a game of catch with his kids is exhausting - even painful.

"All my doctors are telling me I've got diabetes, but they do not really know what kind of diabetes," Coar says.

His weight - now 113 pounds - is plummeting, from 254 pounds just two years ago. His family fears he may not have a future with them.

"It's very hard to see a man who was able to do everything in the world and is hardly able - he can't even pick up his own son anymore," says his wife, Kim.

Now, no longer able to work, Coar - at age 32 - is fighting another battle. It's a battle to get help from Social Security's disability program.

"Social security feels that I am really too young at this point to collect social security," Coar says. "What they're basically telling me is you can go out, still work."

Coar's case is not unique. This year about 40,000 Hoosiers will seek disability, and thousands will be denied. If they want to appeal, they face a lengthy waiting list - and skepticism from Social Security if they're deemed too young.

"I think it's ageism," says Kim Coar. "They feel like if you're somebody who's young, they shouldn't have to be on Social Security."

Attorney Philip Price has 100 disability appeals on file. Many of them are for Baby Boomers in their late 30s and 40s who suffer from unusual medical conditions.

"There are some people who don't have a condition which is scheduled or listed as impairment," Price says. "(Social Security's) standard then becomes you can't do work that exists in the national economy. Pretty tough standard."

And it's a tough and time-consuming waiting game.

Just the first steps in filing for disability - paperwork, physical exams and an initial answer - take an average of more than three months. Appealing a denial can take nine months or more beyond that.

As that year or more goes by, the medical and financial pressures get even worse. Families must be fed, kids clothed, bills paid for. And there's no guarantee of a disability payoff.

Social Security officials say Indiana cases are handled faster than anywhere in the Midwest.

"We've actually expedited hearings in those cases where there's that dire a need," says Paul Lillios, who oversees the department's appeal process.

Lillios denied the agency has any age-bias.

"That really is not part of what we do," he says.

But documents on the administration's own website acknowledge there are problems.

"The current disability process can be confusing and unwieldy," it says, "with many applicants waiting too long for initial determinations and appellate decisions."

Administrators say they're trying to fast-track cases where a disability is so obvious that a formal hearing is not necessary.

"We brought our legal resources, attorneys and paralegals actually up to the front end of the process," Lillios says. "In other words, we triage cases."

But some applicants remain caught in red tape. Take 36-year-old Shelley Kendall, who applied for disability last September.

"The length of time that it takes, in my opinion, is inexcusable," Kendall says.

Ten years ago, Kendall was an active, athletic dirt-track driver. But in 1997, she says, she was diagnosed with fibromyalgia, a painful muscle disorder. A brain aneurysm in November left her legally blind.

"Social Security said fibromyalgia is not normally something that they pay on," Kendall says. "They're real happy to take your money, but when it comes time to claim it, it's real hard to get it back."

Mary Hulseman, Kendall's doctor, says Social Security makes it especially difficult for applicants whose disabilities are not obvious.

"I think if somebody lost a limb, they have an objective finding and it's much easier to get disability," Hulseman says.

For Kendall and the Coars, the denial of benefits can wreak havoc on a family's financial health as well.

"I keep telling my wife I want my spirit back," says Coar. "I want my life back."

Part Two

Warren Theobald calls his computer his medical lifeline. With it, he can research the diseases ravaging his 32-year-old body.

"I live day by day, and if it wasn't for family and friends, I wouldn't have made it," he says. "I've been fighting illness since I was nine years old. I had cancer twice. Rib removal due to radiation. Now this heart problem and diabetes come up."

Doctors' letters document the enlarged heart that forced him to quit his job. But Theobald can't get disability. He's been turned down repeatedly, he says, because he's too young.

"They need to forget about the age and worry more about the actual disability," Theobald says.

But Theobald is not alone. Thousands of Hoosiers denied disability are waiting months, in some cases years, to have their appeals heard.

"There have been times where files have sat at people's desks for months," says Katherine McKewen, who counsels disability applicants.

She says one reason for the delays is low pay that causes rapid turnover at appeals offices around the country.

"Perhaps the review process in their mind is having a system of checks and balances," she says. "In my mind it's a way of prolonging the agony."

To get benefits, applicants must have a condition that Social Security recognizes as a disability - one that prevents them from doing any work. But if you're young or your impairment isn't physically obvious, it can be tough even getting a hearing.

Just the first steps in filing for disability - paperwork, physical exams and an initial answer - take an average of more than three months. Appealing a denial can take nine months or more beyond that.

Social Security officials say Indiana cases are handled faster than anywhere in the Midwest, and that age is not an issue.

"We hear and decide the cases as they come based upon the facts and the evidence," says Paul Lillios, who oversees the department's appeal process.

But not everyone's convinced Social Security is handling that process well.

"Unfortunately, this is the federal government at work," says Sen. Evan Bayh, D-Ind. "There's a lot of bureaucratic runaround and a lot of delay."

Bayh questions why legitimate cases appear to be routinely denied several times before being approved. He says he plans to look into the matter.

"At least we can get a speedy answer, hopefully, a positive one," Bayh says. "And if not, at least we can shorten the time in which a final resolution is reached and people can pursue their rights in court."

Warren Theobald - with a defibrillator in his chest and taking 22 medications a day - says he just wants his life back.

"I paid out Social Security from the time I was 16 until I was disabled," he says. "Now they're saying I can't have any of it. That's real frustrating."

Part Three

Ruth Van Liew - 48, a grandmother - was denied not once but twice for Social Security disability because the government said she wasn't sick enough.

"She ended up dying anyway, before she even had a hearing to show them how sick she was," says Sharon Hartwell, Van Liew's sister-in-law.

Just one month ago, Van Liew died of chronic hepatitis and liver failure. She had waited fruitlessly and in pain 15 months for a disability hearing.

"Nobody ever saw her," Hartwell says. "All they went by was the paperwork.... It's bad enough that they have to suffer from the illness that's affecting them, but they have to go through not being able to get the help."

Van Liew's frustrating attempts to get Social Security aren't unique. Our investigation found that thousands of Hoosiers denied disability have waited months, in some cases years, to have their appeals heard.

"Unfortunately, this is the federal government at work," says Sen. Evan Bayh, D-Ind. "And there's a lot of bureaucratic run-around and a lot of delay."

Since May, when we took our findings to Bayh, who promised to look into the delays, we've received dozens of viewer calls and e-mails. The long wait is just part of it. You've told us about paperwork re-routed to other states and repeated denials for seemingly clear-cut cases.

"We're going to look into the pattern of denials and see if there's any pattern to the types of cases being turned down," Bayh says.

Bayh has set up some fact-finding meetings between his staff and social security administrators, but so far there have been no reforms.

Just the first steps in filing for disability - paperwork, physical exams and an initial answer - take an average of more than three months. Appealing a denial can take nine months or more beyond that.

Van Liew's family expected a six-month wait, but certainly not 15 months.

"I just trusted in the system," says Rose Hartwell, Van Liew's sister. "I was very, very shocked how it works."

There is no headstone yet for Ruth Van Liew - her family is still making the arrangements. Her family says they're trying not to be bitter about her disability battle. By talking publicly about the story, though, they hope to spare other families from the pain and frustration they had to go through.

IU law professor David Orentlicher, who's also a doctor, has treated patients who applied for disability and waited, and waited and waited.

"We have a broken system that's overloaded, and now we have aging babyboomers," Orentlicher says. "Among those who are turned down on appeal, 50 percent are reversed, so that tells us something's going wrong, that many mistakes are made."

And Orentlicher says the longer it takes, the more people drop out.

"The perverse result is that the person who's most disabled, who's most deserving, is least likely to try to complete the process," he says.

Van Liew's family says they did try. They submitted medical records documenting her illnesses. They turned to a staffer from U.S. Rep. Steve Buyer's office, but she had no luck either.

Shortly thereafter, Van Liew received another denial letter from Social Security: "We have determined that your condition is not severe enough to keep you from working."

The denial letters are especially frustrating to Van Liew's sister, Rose Hartwell, who's a registered nurse.

"I just knew that they hadn't looked at her files," she says. "They hadn't read her files."

Buyer says Congress is trying to get more funding to increase staffing and salaries for Social Security to help ease the problem.

"The claims processing is backlogged," he says. "Those who are working the Social Security office really are overworked and underpaid.... It's almost come to the point where Social Security denies (applicants) almost per se and forces you to go through this appellate process."

Social Security officials have acknowledged that employee turnover is a problem. In the Indianapolis office, where the average starting salary is $22,000 a year, officials hired 24 caseworkers since October, but lost another 33.

Agency officials would not comment for this story, but they have told Bayh that they are "redesigning the claims process."

It all comes too late for some like Ruth Van Liew.

"If the system remains the way it is, I don't think it'll work for the honest American people," says Rose Hartwell. "I think it's failing a lot of people right now."

Tips For Applying

• First, get complete documentation for your case, including all medical records.
• Make sure you include addresses, dates and the like. Missing documentation could set you back in the process.
• Next, have your doctor send a letter to support your claim.
• Write your own letter detailing how your disability prevents you from working.
• Contact your Senator in Washington for help. Sen. Evan Bayh's Indianapolis office: 317-554-0750. Sen. Richard Lugar's Indianapolis office: 317-226-5555.
• Finally, it can help to have an attorney, although you'll have to pay the legal fees. Social Security will provide you with a list of attorneys who specialize in disability cases.