Social Security Disability Insurance operates on the idea that if a person or their family have contributed to the workforce and paid into Social Security, they should be able to receive money in the event of a medical condition preventing them from pursuing employment. You know, socialism. Instead of sticking a hook at the end of your mangled arm and going back to your gynecological practice, you can now live it up on Easy Street, all on the taxpayer’s dime. That’s what some TV pundits would have you believe. But in practice, getting SSD is an extremely complicated and long process. Rachel, an SSD examiner, and Manny, an SSD consultant, explain why:
Research by Evan Symon.
The Application Process Can Take YEARS
On average, only about 4 out of 10 SSD applicants are approved. Part of it is because some claims are literally things like “sometimes at night, I close my eyes and pass out for 7-8h straight. Money please!” Because of people like that, the Social Security Administration needs to have very strict definitions of what makes you eligible for their disability benefits. As a result of all that red rape, the process can often take years and be excruciating for people who genuinely might need help. Rachel gives an example:
“The longest wait a claimant I talked to had was almost 5 years.”
“It was another back claim, and talking to him was depressing. A lot of cases are, because these are people obviously in pain who need money to live, but who are denied because their pain isn’t bad enough … This man with the back claim would spend a long time talking to me about his problems and about how he couldn’t move and tell me stories about how he fell at the store again, or that he hadn’t showered for a week because it hurt so much. We denied him a few times, and when he appealed, he was denied.”
The man eventually got a court date, but due to the backlog of cases, it took another 3 years for a judge to hear his case. Rachel doesn’t know if he got his money in the end, but she’s certain he was in a lot of pain all this time, trying to get help from the only place available to him.
For someone to even look at your SSD application, you need lots of paperwork, forms, proof that you can’t work, and you can’t do any other kind of work in the meantime. The meantime possibly being 3-5 years here. Yet even if you have all that, your case might still get rejected. That’s why jobs like SSD consultant or lawyer exist. It’s almost like the system is designed to only work on appeals. Manny explains:
“I have a woman who works at a big box store. She has gotten worse and worse back spasms throughout the years. All documented. When she finally had enough to go to the doctor, they found out that all the lifting and constant moving through the years did something nasty to her vertebrae. Since she can’t work that long until she’s in pain, it qualifies her for SSDI. She tried twice, and was both times denied. After the second time I recommended a lawyer. I’ve seen cases like hers that are denied, but when it’s appealed it’s accepted.”
But for some people, it’s all too much. Most of us have our pride, and just asking for help from the government once might feel humiliating to some. Asking them for money over 3-5 years, and even going to court? You can’t imagine how hard that must be for some people. That’s why Manny’s client didn’t pursue her claims and just took more Advil for her back. She was a proud Mexican woman who was a rock for her family, and SSDI denials did to her what life couldn’t: they broke her.
“As far as I know, she’s still working through probably even worse pain.”
Fraud Is Exceedingly Rare
Currently, we do not have a sufficiently scientific way of detecting how much pain someone is in, except maybe checking how many times they’ve listened to Elliott Smith this week. This might seem like it would make faking an SSD-eligible injury easy but that is the furthest thing from the truth because of the sheer amount of paperwork involved.
“There are not a lot of claimants outright faking disabilities to get disability,” Rachel says. “There’s not a whole lot to fake. Most injuries and mental illness you’ll need paperwork from doctors and at the very least months of documentation.” The Social Security Administration estimates that less than 1% of all people on disability there are fraudulent because it takes 6 months and 10 Google spreadsheets to coordinate one dinner party when you’re an adult. Getting a bunch of doctors to help you cheat the SSA? Not going to happen that often. Some people do exaggerate their conditions, though, but they get caught FAST.
“I have a good example for this. There was a man. He was 31. He claimed that he could barely walk and that his wife had to drive him everywhere. I called him about a few questions I had on his application, and when he said ‘Hello’ I could hear a radio on and what sounded like driving. I said who I was and what he needed and I heard a faint ‘Oh shit’ and I heard what sounded like a car turning off somewhere.”
“We talked about what he needed, and before I hung up I asked if he was driving. You know what his answer was? ‘It’s a good day, my legs are feeling fine’ … We denied him, and a major reason was that he was pretending it was way worse.”
Think of it as a resume. Of course you’re going to inflate it or make it sound better, but you can’t get greedy or stupid. If you put “Fluent Spanish” on a resume and you can only say “Hola” (while pronouncing the H) during the interview, it looks bad. The same goes for an SSDI application. If you’re claiming severe hip problems, but the doctor writes in his report you really only have mild pain, it won’t look good. In the end, you should be honest. That way, you might actually get what you want. Manny explains:
“There was a person I was consulting who had an accident and lost the use of his left hand. It sounded alright over the phone, and he had the papers showing it. Social Security sent him to a doctor where he was able to do some simple hand strength tests, and they downgraded how severe it was. He was denied, and because everything else was in order, it was obvious that’s the reason he was denied … It was so painful to move his hand, that he was desperate and embellished to make it sound worse that it really was so that he could stop working.”
“It backfired on him, and I had to tell him that he couldn’t do that. He was honest the next application and was accepted.”
Wow. I think we just found the only place in the real world where honesty might actually pay off!
Some Claims Can Get… Unusual
“There was another stupid claim I got,” Rachel recalls. “It was a blindness claim. These require extensive paperwork, because it’s not permanent disability. There’s therapy to teach you to cope and transition and you won’t be on it for more than a year. He had applied, but gave no medical paperwork except a prescription for glasses that wasn’t in his name. This was an automatic denial, but I called to make sure. And that’s where I got the full story he hadn’t given me in the first place. He had his brothers’ sunglasses and wore them. They were so dark that he couldn’t see, but filed disability because it was his only pair of sunglasses and he thought they could get him a pair for his prescription.”
And I know that, ironically, a lot of you are thinking right now that there must be something wrong with your eyes because there’s no way that you just read that correctly, so let’s repeat it:
“I know, it’s confusing. He basically took one prescription, said he couldn’t see with them on, and expected to get on disability for blindness so that he could afford new glasses. That was his plan. I had to get my supervisor on the phone, because I knew she wasn’t going to believe me, but he said it again. We gave him other numbers to try, and let him know that wearing dark sunglasses did not make him legally blind. The doctor who looked it over had in his notes: ‘This made my day. Deny him.’”
I couldn’t confirm it, but I assume that the man later filed for Social Security Disability for “loss of height” after going down some stairs.