The U.S. Government Accountability Office reports approximately 10,000 disability applicants die each year while awaiting a decision on their disability application.
INDIANAPOLIS — Mornings are hard for Kimberly Stiles. She takes a pill to simply help her get out of bed.
A 13News investigation has found that system is plagued by administrative and legal mistakes that inflate processing and wait times, improperly withhold disability insurance payments from applicants who deserve them, and cost American taxpayers tens of millions of dollars annually in unnecessary legal fees.Stiles first applied for disability benefits more than four years ago following repeated bouts of dizziness and severe migraine headaches that forced her to leave her job.
“It’s a big problem,” said Annette Rutkowksi, Stiles’ attorney who’s been practicing disability law for more than 20 years. “So many decisions these days seem to cherry pick every ‘normal’ finding and skip over anything that supports disability.” “I would love to be working right now. I’d love to have my life back pre-injury,” he told 13News. “I can’t take care of my family financially, and it just wears on you.”Jonathan Harris was denied disability benefits after an administrative law judge based his denial on medical records submitted for a different patient.
“They fought the case and tried to say it was a harmless error,” the attorney said. “I’ve never seen things quite this bad, this inaccurate. That’s what the big concern is: that no one seems to care about getting it right, and we see mistakes that happen like this all the time.” Millions of other Americans are denied benefits because the government determines they do not meet the criteria for being “disabled.”an individual to be approved for disability benefits. Those conditions include diagnoses such as ALS, Duchenne muscular dystrophy, several cardiac conditions and many forms of cancer.
“Our agency is now at its lowest staffing level in 25 years,” Jeff Nesbit, the Social Security Administration’s deputy commissioner for communications, wrote in September. He said the agency has since the start of the pandemic, leading to deteriorating service and longer wait times.
And for applicants like Stiles and Harris, those waits are just the beginning. Disability applicants who are denied after their initial request for benefits then have four levels of appeal: reconsideration, administrative law judge hearing, Disability Appeals Council review, and a federal court appeal – that can add years to the process.for an appeal hearing with an administrative law judge are growing. In Indianapolis, Fort Wayne and Evansville, the wait is between 10 and 11 months.
In 1980, Congress passed the Equal Access to Justice Act . It authorizes an attorney, who represents someone suing a federal agency, to be reimbursed for legal fees if the court finds that the position of the government was “not substantially justified.” Put another way, if a federal court finds that the Social Security Administration denied a disability claim without substantially justifying the denial, the agency can be required to reimburse the applicant’s attorney for their legal fees.
Four-year-old Valkyrie Cass was diagnosed with cerebral palsy following a stroke that she suffered when she was born. She has seen a team of doctors at several pediatric hospitals throughout the Midwest, and several of those doctors encouraged Cass’ parents to apply for SSI to help pay for her treatments and care.
An exam report from the government’s doctor states, Valkyrie’s left upper extremity is “normal” and “full strength.” That finding contradicts several medical exams conducted by Valkyrie’s doctors and the limited strength and function that 13 Investigates observed as Valkyrie unsuccessfully tried to use her left hand to zip her coat and play with toys.
“The judge used the same inaccurate exams as the basis of his conclusion and denied her again. I was shocked. We knew where the problems and errors were and spelled all that out, and it fell upon deaf ears,” the attorney said. “He wanted to work so bad. That’s how we grew up – working,” said his sister, Shannon Gilbert. “When he couldn’t work, it was devastating to him.”Shannon Gilbert holds a photo of her brother, James, who was denied disability benefits despite suffering daily epileptic seizures.
Outside the office, he recorded a video explaining his battle with seizures and his ongoing fight to get the disability benefits he said he was entitled to receive. The video ends with James uttering three final words as the sun shines behind him: “See ya everybody.”A few minutes later, James Gilbert killed himself outside the Social Security office that had denied his disability benefits.
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