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Image: Michael Spratt
Jennifer Shephard  /  The Elkhart Truth
Michael Spratt, 57, says he has limited use of his shoulder and other injuries that leave him unable to work.
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By Senior Editor
msnbc.com
updated 12/17/2009 11:04:46 AM ET 2009-12-17T16:04:46

With an aching shoulder and sore hip, Michael Spratt figured he’d have to apply for disability benefits someday. He just didn’t think that day would come so soon.

The 57-year-old was laid off from his job unloading chemicals from tanker trucks at the Rollie Williams Paint Spot in Elkhart, Ind., in January. The work involved some heavy lifting, and Spratt said that over the past couple of years he couldn’t do it without assistance.

“Without the help, I couldn’t have worked. The company, they more or less put up with me, because I worked there for 20 years. But it got to the point where if I had to work by myself, I wouldn’t have been able to do it,” Spratt said.

With business slowing, Spratt found himself out of a job along with more than a dozen colleagues. He doesn’t fault his old bosses for letting him go.

“I look at it as a blessing, because I know’d the day was coming that I’m not going to be able to work anymore,” he said.

Now, along with millions of other Americans, he’s turning to the disability system for support, creating an unexpected surge in applications.

According to the Social Security Administration, which runs the two main federal disability programs, new claims for disability benefits rose nearly 17 percent nationwide in fiscal year 2009, to 3 million. Disability filings are projected to rise another 10 percent in fiscal 2010, to 3.3 million new claims.

These applicants aim to join the roughly 12 million Americans who received disability benefits at a total cost of $161 billion in fiscal year 2009, according to the latest figures from Social Security.

‘A big mess’
Advocates and officials say the rising claims are driven by two main factors: the aging of the baby boomer generation and the slumping economy.

“The average age of disability we see nationwide is 50, so the baby boomers have already reached their peak years of disability. That by itself has been driving up volume big-time over the past decade,” said Jim Allsup, founder and CEO of Allsup Inc., a national disability representation firm. “Then they just went into the stratosphere because of the recession.”

With so many new claims being filed, Allsup is worried that the Social Security system can’t handle them all.

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“Basically, it’s a big mess,” he said.

Michael Astrue, commissioner of the Social Security Administration, understands the frustration of Allsup and others who help disability applicants navigate the system.

“If I were in their shoes, I’d be concerned too,” Astrue said, acknowledging that his organization doesn’t have the best track record when it comes to processing claims in a speedy and efficient manner. In some parts of the country, disability applicants can wait years before they get a final decision.

“Where we’re having the biggest problems are states that have a combination of two things: One, the economy is very bad; and two, the state has embraced furloughs," Astrue said. "California, Wisconsin, Ohio are three of the states where we’re really struggling now.”

To help the most overloaded offices, Astrue has beefed up hiring and created special strike teams. There are also plans to open seven new hearings offices by the middle of next year. Still, he admits, it may be a while before the system reaches full capacity.

“Part of the difficulty is these are highly technical, difficult jobs,” Astrue said. “The people we hired over the summer won’t be fully trained and productive for the most part until next summer. So we’re still struggling and limping a bit."

Never been busier
In economically hard-hit northern Indiana, a person with questions about the disability claims process need not look far for answers — the airwaves are peppered with advertisements from lawyers offering to help people apply for benefits.

Attorneys in the field say they’ve never been busier.

“In our practice we have had the largest increase this year in new clients that we have ever had," said Gary Davis, a disability lawyer in La Porte, Ind. "Part of that is because our practice is growing. But probably a bigger reason is because of the economics in our area.

“Let’s say you worked at an RV factory for 20-25 years and you lose your job and you’re 50 or 55, it’s almost impossible to find another job,” Davis said. “Many people that age of course do have serious impairments — they are diabetic, they have heart disease, whatever their impairments might be."

But Astrue, the Social Security commissioner, said many applicants who have held jobs recently may not wind up being approved, unless their medical problems are found to be truly serious.

“Certainly you would expect that we would have a much lower allowance rate for people in that category with recent work history, where the problem may really be economic rather than medical,” Astrue said.

‘Nobody going to hire me’
Not long after being laid-off from the Paint Spot, Spratt filed an application for disability benefits.

He said that his ailments, including a right shoulder on which he had multiple surgeries in the mid-1990s, won’t allow him to get another manual labor job. And with just a 9th grade education — Spratt says he went to work full-time at the age of 15 after his parents got in an accident — he’s not a prime candidate for retraining for an office job.

“Ain’t nobody going to hire me,” he said.

He said a recent visit to the doctor brought some bad news.

“I just went to the doctor and found out I need the right shoulder replaced and the hip,” he said, his voice breaking. “I can’t afford that.”

To deal with the discomfort, Spratt is on prescription painkillers.

“They just upped me. I’m supposed to take three Vicodin a day, but I don’t. I don’t like taking it.”

In mid-October, Spratt got word that his claim for benefits had been rejected, so he signed up with a lawyer and is working on an appeal, a common step in the claims process.

Spratt’s attorney, Robert Rosenfeld, said that until the recession hit, many employers retained people with disabilities by making certain allowances for them.

“If you’ve got somebody who is a marginal employee but is trained and can do what you need him or her to do, they’ll keep them, they’ll make accommodations, they’ll allow excessive absenteeism,” he said. “When you lose the orders, when you lose the business, when you don’t need the employees … you keep the folks who can work 40 to 50 hours a week at a full productive rate. And the folks who were marginal at best get dropped. These are folks who probably qualified for disability but they were working, because they are good solid hardworking folks.”

Twists and turns
In order to get federal disability benefits, claimants must show they are unable to work due to a medical condition that is expected to last at least one year or result in death, according to the Social Security Administration.

It’s a high bar that few applicants meet at the initial application stage, when nearly two-thirds of claims are rejected. Those that are approved tend to be obvious cases — a person in a coma or someone with terminal cancer, attorneys say.

The next step is a “request for reconsideration,” which involves a review of the initial decision. It takes, in general, a few months, and roughly 14 percent of those who seek a review get the original decision overturned, according to Social Security.

The third, and for many applicants the most significant step, involves an in-person hearing before a judge, who must verify the legitimacy of the claim and where new evidence can be introduced. Roughly 55 percent of applicants who push on to this stage see benefits granted.

“It’s the one and only time that an individual who is seeking benefits sits down with the person making the decision,” Rosenfeld said.

It’s also the stage where people who can least afford it hit the longest snags. Applicants who seek a hearing in Dayton, Ohio, face an average wait of 635 days, the worst in the country. Another Ohio city, Columbus, is just behind, with an average processing time of 629 days. The national average is 491 days.

Rosenfeld said this can spawn some tough conversations with clients.

“The good news is we are going to get a hearing, the bad news is it might not be for two years. They say, ‘Well how do I survive?’ I don’t have an answer,” Rosenfeld said.

While some claimants may have significant savings or a spouse who works, others, like Rosemarie Grimm of Goshen, Ind., survive by tapping every source of income they can find.

While waiting for her hearing date, which came earlier this year, Grimm, 50, pieced together an existence by relying on her live-in boyfriend’s disability benefits (he lost one of his arms in 1996, she says), their 8-year-old son’s disability benefit (because he was a dependent of her boyfriend, the boy’s father, he got a monthly check too), food stamps, the Salvation Army and Elkhart County social services.

“When things got tough, I had to rely on different organizations to help. They’re real good out here like that,” Grimm said.

Many ailments, many medications
Grimm, who used to work as a waitress and hostess, initially filed for disability benefits in April 2007, claiming a variety of ailments. Her application was rejected, but nearly two years later, a judge granted her benefits, citing the following conditions: depressive disorder, anxiety disorder, degenerative disc disease, stenosis of the lumbar spine, bilateral carpal tunnel syndrome, status post fracture, shortening of the left wrist, fibromyalgia, erosive esophagitis, and more.

To deal with her many maladies, Grimm said she takes 15 medications each morning.

“I have them all in a row. You just get used to it after a while,” she said.

While Grimm said it was tough to get by as she waited for a hearing date, she wound up being compensated in the form of “back pay,” or past due benefits. Social Security pays successful claimants from just after the estimated onset of their disability, not from the day they are finally approved.

In Grimm’s case, this added up to $51,000 — $35,000 for herself and another $16,000 for her son — based on her awarded benefit of $1,094 per month, she said.

“When I got the money I felt bad, because there are people out there that don’t have any jobs,” Grimm said. “I felt guilty.”

But Grimm said friends urged her to put away her shame and reward herself and her family for their many years of doing without. So she paid ahead the family’s rent and a life insurance policy, and then bought new furniture for their small house on a busy road in Goshen, including three flat-screen TVs and a Sony Playstation, she said.

The family also owns two cars now — a 1994 Buick Park Avenue and a 1997 Ford Windstar — whereas they had none before, Grimm said.

‘Fair amount of judgment’
Cases where an applicant claims a combination of maladies as opposed to a single debilitating illness or condition have become increasingly common, according to Commissioner Astrue.

“We see a lot more combination of impairment cases, where people are alleging a lot of different impairments and saying the accumulated impact of all those impairments equals disability,” Astrue said. “A lot of these cases now involve a fair amount of judgment. It’s sort of a difficult looking into the soul of a person and trying to figure out, given the unique combinations of impairment this person has and the person’s vocational record, can we reasonably expect this person to work.”

“When Congress originally conceptualized the … disability program, it was an early retirement program for workers,” Astrue said. Congress expanded Social Security to include disability benefits in 1956. “What they had in mind were generally blue-collar workers, maybe 50-62 who had hurt their back on the job or that kind of thing and couldn’t work.”

While Spratt, the former paint shop laborer, awaits the reconsideration of his disability claims rejection, he and his wife get by on his $390 a month in unemployment benefits and her income from a waitressing job she’s held for more than 30 years at Elkhart’s Bulldog Restaurant, he said. The Spratts joke that she’s been there so long she’s been through at least one name change at the restaurant and an ownership change.

Even with his aching shoulder and bad news from the doctor about his hip, Spratt isn’t overly confident that his disability claim will wind up being approved.

“I don’t know. They say a lot of people are filing for it, so they might just say, ‘Well, no, you don’t qualify,’” he said. “You give the government money every year. Yet when you need the money, they ain’t going to give it back to you.”

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