Getting disability benefits may be fight of a lifetime

September 23, 1990|By Suzanne Wooton

What happened to Ray Meyer could happen to anyone. He got sick, so he couldn't work. He couldn't work, so he applied for federal disability benefits.

What happened next to Ray Meyer could happen to anyone, too. Instead of getting help, he got the fight of his life.

For months he's gathered extensive medical evidence for Social Security. He's filed and refiled forms -- some of them lost by the agency. He's been turned down twice, forcing him to hire a lawyer, who will get one-fourth of any benefits he may win. He's exhausted his savings, applied for welfare, asked his church for a loan, and now risks losing his small Catonsville home.

Tomorrow, Mr. Meyer finally has a hearing before an administrative law judge. Even if he wins his case, it will be four or five months before he gets any money.

"I never knew anything about bureaucracy, about the inefficiency," Mr. Meyer said. "They're going to take a good family and eventually destroy us and put us on the street."

But he may be successful in the end, because Social Security's own judges award benefits to 60 percent of the people who appeal. Critics say that proves that the agency, which initially turns down two-thirds of the applicants, is rejecting far too many deserving people. And they worry that many eligible people may be among the half-million a year who don't pursue the arduous appeals process.

"Denying disability insurance has never been the mission of the Social Security Administration, yet that is exactly what is happening," Sen. William S. Cohen, R-Maine, said during a Senate hearing this summer.

For years, Social Security's disability program has been attacked -- by Congress, by the federal courts and by many within the agency itself -- as a program bedeviled by complex regulations, delays, lost files and bureaucratic ineptitude. While significant reforms have been made, few have assured that the agency's examiners and judges interpret the law the same way or that people get benefits when they really need them.

"It's a tortuous system," says Robert R. Jenkins, a Baltimore lawyer who specializes in Social Security disability claims.

To get disability benefits, an applicant must have a physical or mental impairment that precludes any gainful work, not just his current job. The disability must be expected to last at least a year or to result in death.

Social Security says that these tough restrictions force disability examiners initially to deny two-thirds of the 1.5 million new applications a year.

When applicants finally see a judge, they often have gathered more medical evidence. Sometimes their condition has worsened, making it easier for the judge to reverse an earlier decision. But frequently, what the judge says boils down to this: "Somebody made a mistake a long time ago. You should be getting disability benefits."

By the time the judge writes a decision and Social Security pays up -- retroactively -- another four or five months have gone by.

When an administrative law judge hears Mr. Meyer's appeal tomorrow, he will be the first person in the year-long process to evaluate Mr. Meyer face-to-face.

After undergoing surgery for bladder cancer, Mr. Meyer, an architectural designer, applied for help last fall, knowing he faced either further surgery or months of chemotherapy that would keep him from working. He'd paid Social Security taxes most of his life. Based on his earnings of $35,000 a year, he figured he could draw roughly $1,000 a month.

Mr. Meyer first was denied benefits in November 1989. Social Security said that although he had cancer, the disease apparently was not progressing and he could work.

"At first I got disgusted and said, 'I'm going to drop the whole thing.' But that's the way the system wins," Mr. Meyer said. In late December, he asked Social Security to reconsider his claim.

By then, he had undergone chemotherapy, which had left him with a side effect known as peripheral neuropathy. He told Social Security he had little feeling in his feet or hands, making it difficult for him to walk on uneven ground, like construction sites, and impossible for him to draw.

At 57, Mr. Meyer thought the chances of finding any other kind of work were nearly impossible. His family tried to live on the small salary his wife earned as assistant manager of a fabric store.

Another 60 days went by before Social Security told him that part of his application was lost. He resubmitted the same forms, updating them with new evidence about physical therapy he was undergoing to regain use of his hands.

In April, Social Security sent him to a consulting physician.

"He pricked my finger, asked if I had an alcohol problem and how my sex life was. I was in and out of the office in five minutes," Mr. Meyer recalled.

A month later, he was denied again, on the same grounds as before. He asked for a hearing before a judge.

According to many familiar with the system, stories like Mr. Meyer's are typical.

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