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Joe Allen of Vermont said his disability claim was denied twice.
Joe Allen of Vermont said his disability claim was denied twice. (Globe Staff Photo / David L. Ryan)

Reform talk passes disability program by

Page 3 of 3 -- Social Security Administration officials acknowledge that decision-making can vary widely because some states do not have as many medical or vocational specialists as others. ''There is a very uneven distribution of expertise," said Gerry, the agency's deputy commissioner for disability and income security programs. He suggested the disparities may even out when the results of various appeals are taken into account, but his spokesman said later that data are ''not readily available" to prove that theory.

To many people seeking benefits, the system can appear to be a maze that only a lawyer can penetrate. If a person is denied benefits during an initial review, there are four more steps that can be taken: an appeal to reconsider the denial; an appeal to an administrative law judge; an appeal to another review board; and, finally, a federal court suit.

As a result, there is a thriving business of thousands of lawyers who file appeals and, if they win their case, are allowed to take 25 percent of the previously denied benefits. In the month of January 2005, lawyers received $68 million in such fees in 20,000 cases, according to a report by the Social Security Administration.

Every year, about 2.5 million people file claims for disability benefits. Of those, 37 percent are initially approved. After appeals, the final approval rate climbs to 53 percent, according to Gerry.

Gerry acknowledged that the system can be daunting, noting that the Social Security Administration employs 1,000 administrative law judges and holds 650,000 hearings a year, making the disability claims process ''the largest administrative law system in the world."

Gerry said he is especially concerned that a poor person with disabilities who cannot afford a lawyer will not get benefits. ''I'm dissatisfied with where it is, and [Commissioner of Social Security Jo Anne B. Barnhart] is dissatisfied with where it is," Gerry said about the disability system. ''However, I'm satisfied we're making substantial progress to improve it, and we will try as quickly as possible to get it to where it should be."

Once a person with disabilities receives benefits, which average $894 per month, few leave the system voluntarily. Only about one in 500 people on disability tell the Social Security Administration that they have improved enough to go back to regular working hours and conditions. Separately, 13,900 of 784,000 cases reviewed by the government in 2003 resulted in a cessation of benefits, a Social Security official said.

Allen's case appears typical of those who experience delays in receiving payments. He did not know about the disability benefits when he went to town officials and asked for welfare assistance.

''It was the most humiliating thing I had ever done," Allen said. ''They said to apply for Social Security."

Allen said his claim was denied his twice. Then, with the help of Vermont lawyer Judith Brownlow, he went before an administrative law judge.

He said he wore shorts on the wintry day, enabling the judge to see that Allen's legs had bloated to 29 inches at the calf because of his medical condition.

The judge overruled the initial denial. ''He was clearly someone who deserved the benefits," Brownlow said. 

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