"Failing The Disabled"
This is the second part in a CBS News investigative series about federal disability program.
Two years ago, 52-year-old Sherry Farner was a manager at a Denny's restaurant. But heart problems, strokes, and kidney failure put an end to her employment.
"I can't be alone, because I fall a lot. This is the hardest thing I've ever been through," Farner told CBS News chief investigative reporter Armen Keteyian. "And I wouldn't wish this on nobody."
When Farner filed a claim against a lifetime of paying into federal Social Security disability, she was turned down -- twice. Even though a rejection letter acknowledged she was severely disabled. But not disabled enough: Unable to perform work of any kind.
"It's a very tough standard," said Michael Astrue, commissioner of the Social Security Administration. "And you can argue whether that should be the standard or not, but I'm stuck with that."
A two-month CBS News Investigation uncovered a system whose own standards have been called into question - a federal agency reeling from budget cuts and high staff turnover. Doctors making decisions outside their specialties, and inexperienced examiners under pressure to keep costs down.
"We're failing the disabled on a very large scale," said Trisha Cardillo, who worked inside the system for years, reviewing 200 federal disability cases a month in Ohio.
She now fights for those seeking disability benefits.
"There were a lot of times when I was fighting with management because I wanted to approve a claim," Cardillo said. "And I had to go through so many steps and - jump through so many hurdles to do that, it just seemed ridiculous,"
All part, says Cardillo, of a culture built on denial. Examiners warned by their superiors that approving claims today could cost the government millions tomorrow.
"So are you saying, in essence, there was a quota system?" Keteyian asked.
"Every state had different numbers," she said. "They know that a certain percentage of people, once denied, will never file an appeal."
CBS News has learned that two-thirds of all applicants denied last year - nearly a million people - simply gave up after being turned down the first time.
Given how many claims are ultimately approved, that could mean hundreds of thousands of Americans are not getting the benefits they paid for - and deserve.
"You can approve too many, and you can approve too few. And they're both wrong," Astrue said.
That's not what the examiner told CBS News. She said that in her state there were quotas to be kept at a certain level.
"It's not the way the system works," Astrue said.
Keteyian said: "That's the way it worked in her office."
"You can always find a disgruntled person," Astrue said.
But we found nearly three dozen former examiners from 14 states who told us about a system-wide "culture to deny."
Part of the reason for that, says Jim Allsup, who employs former SSA employees at his Illinois-based company Allsup Inc., is that there is "an inherent conflict-of-interest between protecting the disability trust fund and providing the appropriate level of service to the claimant."
That's something CBS News found in a review of 50 cases across the country, where patients diagnosed with strokes, heart attacks, even brain cancer, were rejected for disability payments.
"Nobody cares if a case is denied. If you approve it, it will be subjected to intense scrutiny," Cardillo said.
No surprise to Sherry Farner, whose case was finally approved by a judge a few weeks ago - after a two-year wait. But not before losing her car, her life savings, and nearly her home.
Copyright 2009 CBS. All rights reserved. Two years ago, 52-year-old Sherry Farner was a manager at a Denny's restaurant. But heart problems, strokes, and kidney failure put an end to her employment.
"I can't be alone, because I fall a lot. This is the hardest thing I've ever been through," Farner told CBS News chief investigative reporter Armen Keteyian. "And I wouldn't wish this on nobody."
When Farner filed a claim against a lifetime of paying into federal Social Security disability, she was turned down -- twice. Even though a rejection letter acknowledged she was severely disabled. But not disabled enough: Unable to perform work of any kind.
"It's a very tough standard," said Michael Astrue, commissioner of the Social Security Administration. "And you can argue whether that should be the standard or not, but I'm stuck with that."
A two-month CBS News Investigation uncovered a system whose own standards have been called into question - a federal agency reeling from budget cuts and high staff turnover. Doctors making decisions outside their specialties, and inexperienced examiners under pressure to keep costs down.
"We're failing the disabled on a very large scale," said Trisha Cardillo, who worked inside the system for years, reviewing 200 federal disability cases a month in Ohio.
She now fights for those seeking disability benefits.
"There were a lot of times when I was fighting with management because I wanted to approve a claim," Cardillo said. "And I had to go through so many steps and - jump through so many hurdles to do that, it just seemed ridiculous,"
All part, says Cardillo, of a culture built on denial. Examiners warned by their superiors that approving claims today could cost the government millions tomorrow.
"So are you saying, in essence, there was a quota system?" Keteyian asked.
"Every state had different numbers," she said. "They know that a certain percentage of people, once denied, will never file an appeal."
CBS News has learned that two-thirds of all applicants denied last year - nearly a million people - simply gave up after being turned down the first time.
Given how many claims are ultimately approved, that could mean hundreds of thousands of Americans are not getting the benefits they paid for - and deserve.
Keteyian asked Astrue: "One of the state examiners we spoke to, told us that people were singled out, talked to, if they approved too many clients."
Read Part I of the series: Disabled And Waiting
FYI: Resources about disability benefits
"You can approve too many, and you can approve too few. And they're both wrong," Astrue said.
That's not what the examiner told CBS News. She said that in her state there were quotas to be kept at a certain level.
"It's not the way the system works," Astrue said.
Keteyian said: "That's the way it worked in her office."
"You can always find a disgruntled person," Astrue said.
But we found nearly three dozen former examiners from 14 states who told us about a system-wide "culture to deny."
Part of the reason for that, says Jim Allsup, who employs former SSA employees at his Illinois-based company Allsup Inc., is that there is "an inherent conflict-of-interest between protecting the disability trust fund and providing the appropriate level of service to the claimant."
That's something CBS News found in a review of 50 cases across the country, where patients diagnosed with strokes, heart attacks, even brain cancer, were rejected for disability payments.
"Nobody cares if a case is denied. If you approve it, it will be subjected to intense scrutiny," Cardillo said.
No surprise to Sherry Farner, whose case was finally approved by a judge a few weeks ago - after a two-year wait. But not before losing her car, her life savings, and nearly her home.
The all knowing, everwise, ever-criminal Social Security Administration. Mine is in located in Richmond, VA. Where's yours?
Their reasons were that they felt I was over-exagerating my pain and illness, and I had repeatedly told my doctors (when asked how I felt today) "Okay considering". (Meaning I am enduring pain and dealing with problems as I usually do.) The reviewers say I stated "I am Okay. No pain, no ilness." Another reason was that I "felt well enough to go to Florida, so I must not be in too much pain."
I went Florida alittle over a week to try and work for a friend of mine (it would only require about 2 hours a night with a total of 6 nights involved and a few emtpy days in between those 6) This friend understands the nature of my illness and had made allowances for me. I was to ride down with some other persons working for him as well, and then I could stay at his home in a private room so if I did not feel well (as often the case is) I could remain in bed without being bothered. Also if I could not attend the event for any particular night, I could stay in bed as well. A perk of working for this individual is that by coming to Florida, he will reimburse all gas remoney (with receipt) and he makes arrangements to feed us; either through the grace of his good natured wife who cooks some of the meals; or at a restaurant in the area. Another perk is that he obtains tickets for us to enter Disney World a couple of times while we're there as we have some days and nights that we do not have attend one of his events.
This last trip I was able to attend 3 out of 6 of his events (where I was stationed in a chair in one place for the night.) , and visited the Disney park (he chauffers us all) about two times out of the four times that the others went.
-I attended the park on the first day from about 10:00 am to 4:00 pm .
_I missed the second day they went due to my illness.
-I attended the park from about 5:00 pm to 9:00 pm on the third visit.
-I attended the park from about 1:00 pm to 7:00 pm on the fourth day they visited.
The others from my group that visited the park were there from open to just about close on all four days. And each day that I was able to attend, I did so in a rented wheelchair (some of the rental paperwork which I still have.)
On the day of my hearing the judge was trying to hurry up with the case, and kept cutting me off when I was trying to explain what my life is now like with this illness. The decision was actually made in the weeks and months after the hearing took place by an examiner that was not present, is not able to ask me questions but can have extra files or paperwork sent to him to make his decision.
I must now wait for 15 months for another hearing to address these issues, at which time I fully expect their office will find other things to bring up after the hearing,; thus throwing me back another 15 months.
In reference to the previousissues.
- My response to my doctors is "Okay, considering", which they see as "He's okay".
- I am not exagerating my suffering with this. If anything, most times I try to play it down and not let everyone around me know how bad my pain actually is.
- I now have gotten in touch with some of the people who attended that particular series of events in Florida, to ask them to either attend the next hearing or send affidavits explaining what they witnessed of my experiences on that trip. And I will bring the paperwork with me showing that I rented wheelchairs.
Just to throw more fuel on the fire in dealing with this process that is quite obviously tainted against those of us that apply in what can only be described as criminal in what they are doing. There is a movie (based on actual events?), starring Matt Damon as a young lawyer on a case where an insurance company (Great Harvest) adopted the standing operating procedure of denying most every claim they received in hopes that the majority of the policy holders would eventually, and quite simply give-up; thus leaving the company to enjoy a sizeable financial windfall. What IS the difference here.
Then they send you to a doctor who specializes in a completely different field; but that doctor is, in my case, cardiologist who the judge decided had superiority over the orthopedic surgeon who said I was "definitively disabled" because the cardiologist was also an Internist. The cardiologist refused to re-examine me because his contract with the SS prohibited it, but said that the surgeon was "world famous" and if he could see me he would revise his report. The SS wouldn''t hear of it.
The main problem I see dealing with an SSD claim is (time line) Social Security Administration will send a form to be filled out and demand you return the form in 30 day''s or else.
Now after you send the information to them you are lucky to hear back from them in a year or even two.
This is because in all the laws listed in CODE OF FEDERAL REGULATIONS their is no (time line)they must follow, this is why people wait 2,3,4,5,6,7,8 years to finaly get a claim resolved.
I believe it is set up this way to discourage folks from makeing a claim.(WRONG and a CRIME!)
BUT NO TIME LINE FOR A SSD CLAIM.LOLOLOLOL
This is because after you have used up your usefulness and are now a liability the federal government turns there head,they know you are sick,weak,tired and can not fight for your rights.
I say we put a (6 and pay) time line starting TODAY NOT NEXT YEAR OR WHEN Congress FINDS TIME.(6 mounths after a claim is filed payments must be paid to a claiment IF their are (any) (sever)medicaly determinable conditions)PEOPLE ARE HURTING AND SOME DIEING FOR GOD SAKES! while are leaders drink and dine on every Americans hard work and taxs we pay.
Then ask us to vote for them,they promise to make a change. LIES all LIES.
SHAME ON ALL OF YOU ELECTED OFFICIAL''S FOR LETTING THIS HAPPEN IN THE COUNTRY I LOVE, SHAME ON YOU!
Signed: "6 years and still fighting for resolve"from Michigan, The good old USA.
You stated, "The ex-employee they talked to was obviously not following the proper procedures for their allowances and was in trouble for other reasons."
Actually, dear, I was never "in trouble" at DAS, and my performance was repeatedly good enough to warrant promotion to a training position, but your vote of confidence is much appreciated. I left because I grew a conscience--and because the weather in Ohio during the winter stinks.
Again, I don''t think you should assert so strongly that the way things are in your little corner of this world is the way things are EVERYWHERE. They aren''t, and you have no exposure to what has gone on in states around the country, nor do you actually know or follow the law. Not that it''s your fault--you weren''t trained to follow the law, and I''m sure you are just as overworked, underpaid, and (at least occasionally) stressed out as most adjudicators are. I think we should funnell some of the tax money being shipped overseas BACK INTO SSA. You wouldn''t mind a raise and a few extra adjudicators in your office to lessen your caseload, would you?
Trisha Cardillo
Buford, GA
God Bless,
Claire Brooks