On Social Security Disability’s Clogged Pipes

Late last week, the New York Times carried an article discussing Senate inquiries into whether disability insurers were gaming their financials by obliging claimants to apply over, and over, and over, and over… for SSDI.

Sick and injured people must often wait more than a year before their claims can be decided by one of Social Security’s administrative law judges, a delay Mr. Grassley called “abominable.”

“The last thing those who rely on Social Security need is for insurance companies to be clogging up the system by forcing ineligible applicants to apply,” he said.

Mr. Grassley told the insurers to report on how many of their claimants they had compelled to apply for Social Security in the last five years; how many appeals they had required people to file; and what methods they had used to screen the people beforehand to make sure they truly had a chance of qualifying for the government benefits.

The New York Times reported in April that disability insurers were making claimants apply for Social Security even when they did not qualify and were cutting off insurance checks if the claimants failed to do so.

I’m not in a position, myself, to comment on those allegations from an insurance point of view – it’s outside my area of expertise.

However, I have had the misfortune of experiencing the mess that is Social Security from the viewpoint of helping my disabled wife through the process.

I don’t think the problem is (or “is just”) disability insurers clogging the system.  Our experience was that if you weren’t obviously disabled (paralyzed, comatose, missing eyes or limbs) or weren’t near retirement age, your objective was to get through the initial review and the second review as quickly as possible, so that you could hire a disability lawyer and join the 2-3 year long queue to get in front of a judge.

The Social Security Disability standards are rather arcane, and one has a tendency to wonder about some of the civil servants involved.  For example, the first denial my wife received included a regurgitation of her doctor’s opinion about her condition…reversed.  “Cannot bend and pick up 25 pounds” became “is able to bend an pick up 25 pounds”, for example.

Look, if disability insurers have knowingly been forcing non-qualifying claimants into the SSDI system repeatedly, I agree that needs to stop.  However, given private disability insurance is always secondary to Social Security, it’s understandable that insurers would want eligible folks to claim those benefits.

The likely problem arises from Social Security’s definition of “eligible” being so fuzzy in practice, and the SSDI claim process being so onerous that no one in their right mind would want to go through the process, but for desperation, masochism, or duty to a private insurer.

I don’t know whether disability insurers actually aggravate the mess of Social Security Disability.  However, I think there are plenty of other potential areas of improvement in the process that could be tackled which would improve the process tremendously.