Why Social Security Disability Claims Are Taking So Long

Unlike Social Security benefit payments, which are codified in law, spending on SSA operations is subject to the annual federal budget process. Congress approved  $14.1 billion for the agency for the 2023 federal fiscal year, which ended Sept. 30. That was a $785 million increase from the prior year but $645 million less than the agency requested.

Tight budgets and staff attrition have had “disastrous effects on customer service,” the American Federation of Government Employees (AFGE), a union that represents more than 42,000 federal SSA workers, says in a January statement urging Congress to enact a long-term funding increase.

AARP has long campaigned for customer-service improvements at the SSA, meeting with senior agency leaders and calling on Congress to adequately fund Social Security operations and ensure those dollars are used to upgrade service. Since late 2022, AARP members have sent nearly 1.2 million messages to members of Congress urging them to boost spending on SSA customer service. 

“Ridiculously long wait times for decisions can be devastating for families across the country,” says Tom Nicholls, an AARP government affairs director focusing on Social Security. “It’s wrong, it’s frustrating, and it has been going on for far too long. Americans have paid into Social Security their whole working lives. They have done their job, now it is time for Congress to do theirs and fix this now.”

SSA officials say appropriations over the past decade have only been sufficient to cover rising fixed costs such as rent for office space, postage and cost-of-living adjustments to federal workers’ pay, leaving little or nothing to alleviate the growing customer-service problems. But they also point to a deeper, structural problem in how disability claims are handled.

State disability offices struggling

When someone applies for SSDI or SSI, the decision on whether they qualify on medical grounds is made by state-level agencies called Disability Determination Services (DDS). Federally funded but state-run, DDSs make the initial call on a disability claim and handle reconsideration if it is sought. And they, too, are hemorrhaging staff.

The DDS workforce declined by 16 percent nationwide from 2010 to 2021, according to data from the Center for Budget and Policy Priorities. Attrition exceeded 20 percent during that period in 13 states and Puerto Rico.

Those losses are taking a toll. “From the time you file with Social Security and it gets sent to DDS, to getting the decision on that application, it’s taking over a year — 14 to 15 months,” Heard says.

It isn’t just the quantity of personnel lost. High attrition is costing the state agencies expertise, “with many losses being experienced in the disability examiners,” says Mark Hinkle, an SSA spokesperson.

Examiners weigh the medical evidence to determine if an applicant meets Social Security’s definition of disability. “Although DDSs continue to hire, the full development and training for a new disability examiner can take two to three years,” Hinkle says.

Changes in the process for assessing claims have also contributed to the slowdown, he says. Legislation passed by Congress in 2015 required that a medical or psychological consultant review every disability claim (previously, some cases could be handled solely by DDS examiners). The advent of electronic medical records expedited information-gathering but also significantly increased the amount of evidence to be considered for each claim.

And ongoing modernization of the national case-processing system has meant “a learning curve at the DDSs,” Hinkle says.

“DDS is a major bottleneck in the process — both at the initial claims level and reconsideration,” says Rich Couture, chief negotiator for the AFGE.

While DDSs are funded with federal dollars and make decisions on federal benefits, their workers are state employees. Staffing and wages are determined by the states, and DDSs can be affected by state-level hiring freezes and furloughs.

So when the DDSs have problems, the effect ripples throughout the Social Security disability system. And they are “riddled with problems,” says Kathleen Romig, director of Social Security and disability policy for the Center for Budget and Policy Priorities.

“These places are a complete mess,” she says. “The staffing at DDS is worse than SSA. No one wants to work there and they’re miserable and they don’t pay very much.”

Backlog balloons

With the growing delays in disability decisions, the SSA’s caseload of pending claims has swollen. In 2019, just before the start of the pandemic, about 600,000 applicants were awaiting initial determinations on their benefit requests; in 2023, for the first time, the backlog crossed the 1 million mark.

One of those caught in the logjam was Mike, 49, a security systems analyst and Army veteran from the Dallas-Fort Worth area.

Mike (who, like Jose, agreed to speak if his last name was withheld) was diagnosed in 2021 with two forms of cancer. No longer able to work, he filed a claim for SSDI in March 2022, getting legal help right from the start.

“I did a little bit of research and found it was much easier to pay a lawyer to get it done right,” he says.

Mike got what qualifies these days as a relatively quick decision, in four months, but it was a denial. He requested reconsideration in August 2022, but the SSA told his attorneys that the case went unassigned for seven months, until March 2023. He was awarded benefits in August, 17 months after his initial application.

Hinkle says the SSA is taking steps to ease the gridlock. The agency has dispatched about 300 of its federal employees to DDSs across the country to help process claims. It’s boosting funding for salaries at the state offices, offering hires more training and mentoring, and reducing the time it takes to complete background checks to get staff on board faster.

Still, there are no quick fixes. For SSDI and SSI applicants, shorter wait times for determinations depend on many factors, including “sufficient and sustained funding by Congress,” Hinkle says.

While the 2024 federal fiscal year began Oct. 1, Social Security, like other federal agencies, is being funded at fiscal 2023 levels under continuing resolutions passed by Congress in mid-November and mid-January to avert a government shutdown. The new congressional deadline for adopting a fiscal 2024 SSA budget is March 8.

The SSA portion of President Joe Biden’s fiscal 2024 budget proposal, submitted in March, seeks a 10 percent funding boost for the agency, to $15.5 billion. The DDSs would receive $2.9 billion under that plan, an increase of more than $350 million from the current budget.

The proposed spending “provides the necessary resources to maintain SSA and DDS staffing, fund adequate overtime and support additional case-processing costs that would allow us to increase the number of disability cases we can complete,” Hinkle says. “Receiving less than the president’s budget request will harm our processing capacity and increase wait times.”

AFGE contends it will take more than that to right the ship. The union is calling on Congress to approve an additional $20 billion in supplemental funding for the SSA, spread out over 10 years, including $2.5 billion to bring staff back to 2010 levels and $3.2 billion to improve employee benefits to aid recruitment and retention.

For now, though, “the system is what it is,” Mike says. “If you don’t have the patience, it’s going to be a painful wait.”

After two denials, Jose successfully resuscitated his disability claim with help from a legal aid group.

Gabriela Hasbun

Can legal help speed up your disability claim?

Having an attorney or professional disability advocate take your case can be an important step in securing Social Security disability benefits, and in doing so faster, according to the National Bureau of Economic Research.

In a 2022 study, the nonprofit research organization found that legal representation early in the process increases the probability of getting a positive decision on an initial benefit claim by 23 percent.

That “leads to earlier disability awards to individuals who would otherwise be awarded benefits only on appeal,” the report states. “By securing earlier awards and discouraging unsupported appeals, representation reduces total case processing time by nearly one year.”

“What we find is that they really do provide a big benefit for a lot of applicants,” says Nicole Maestas, director of the research group’s Retirement and Disability Research Center and coauthor of the study. “They help claimants put those applications together in a way that can be approved.”

In most cases, you won’t pay up-front fees for legal help with a disability claim. Lawyers get paid only if you win, and the fee comes out of “back pay” — past-due benefits you would have received had Social Security approved your application at an earlier stage.

The fee is capped by Social Security at 25 percent of the past-due amount or $7,200, whichever is less. If there is no back pay — something John Heard, a longtime disability lawyer in San Antonio, says happens “fairly often” — there’s no fee, even if the client receives benefits going forward.

“If someone can find a legal aid service that would provide help, that would be a good first step,” says Richard Johnson, director of the Program on Retirement Policy at the nonprofit Urban Institute. “The applications are complicated and there are rules people don’t understand.”

When Jose, the Bay Area factory worker, was sidelined by multiple physical and mental health issues, he applied for SSDI himself, by phone. His initial claim, filed in 2016, was denied, as was his subsequent request for reconsideration. In late 2019, he contacted a legal aid organization for help with the next step, an appeal hearing.

In August 2021, a month after the hearing, an administrative law judge approved Jose’s application and awarded benefits dating back to June 20, 2016, the date the judge determined that Jose became unable to work due to his disabilities.

“I’m so grateful that I went and asked for help,” Jose says. “Thanks to them, I’m on disability and I don’t have to be on welfare.”