Her Home and Health Hung in the Balance
Tucson, Arizona – Her dire financial straits forced Lynn Eddins to put her house on the line. To cover medical bills while she awaited approval of her disability claim, the Tucson resident took out an equity line of credit against her home. But even that was chewed up in huge chunks as she persevered during the long, drawn out process to receive her federal entitlement.
For years, Ms. Eddins fought against bulging discs, struggling to stay on the job she loved as a rehabilitation worker for the visually impaired. All the while, her constant back pain grew worse.
In 2003, as she was afflicted by a sciatic nerve and began to lose feeling in her right leg, she had surgery on the two lower discs in her back. However, doctors found the two discs above were also in bad shape and operated on those as well. They also found a cyst behind the T-10 and T-11 thoracic vertebrae. “They were pretty concerned about that,” Ms. Eddins said.
“My doctors wanted me to quit after my first surgery, but I didn’t because I loved my job,” said Ms. Eddins, now 59. “But I got to the point where I couldn’t do it any more.” Shortly after a second back surgery in 2006, she resigned from her job.
In the months before she quit work, she looked into the process of getting Social Security Disability Insurance (SSDI), and several of her rehabilitation patients said she should contact Allsup, which she learned is the nation’s leading SSDI representation company. So when she ended her employment, she turned to the leader for help.
Allsup CEO and founder Jim Allsup started his company in 1984, after working for the Social Security Administration, to help people just like Lynn Eddins collect SSDI benefits. A nationwide company with headquarters in Belleville, Ill., near St. Louis, Allsup’s success rate is a staggering 97 percent. The company is so highly regarded that the Better Business Bureau presented Allsup its Torch Award for excellence in customer service. Since 1984, the disability advocacy company has helped about 100,000 people nationwide obtain more than $1.5 billion in SSDI and Medicare benefits.
The wait time just to process a case can be daunting. At the Tucson office, a claimant will wait an average of 598 days for a favorable or unfavorable initial decision (as of June 2008). Across the nation, the waiting lines are getting even longer.
A key reason for this growth is the shrinking Social Security Administration (SSA) field staff, largely due to retirement. SSA was 30 percent smaller in 2002 than 20 years before. Meanwhile, since 1990, the number of disabled workers drawing SSDI benefits has more than doubled, from 3 million to 6.8 million, as the aging baby boom generation begins to put far greater demands on the agency’s resources.
About 1.4 million disability claimants wait for their cases to be resolved. The benefit provides individuals who have severe physical and mental disabilities with living expenses when they are no longer able to work. Some wait more than two years for decisions in their cases.
In a report released Jan. 7, 2008, the Government Accountability Office said rising numbers of disability claims, staff losses and turnovers and management weaknesses have contributed to the disability backlog and longer waits by claimants for resolution.
From the top down, SSA readily acknowledges the problem. “The past few years have been tough for field offices,” said Michael J. Astrue, SSA commissioner, in testimony before the House Committee on Ways and Means in April 2008. “As overall agency employment dropped from 63,569 in 2003 to 60,206 at the end of 2007, field offices felt the effect of staffing losses more intensely because so many of our activities mandated by law are performed in our field offices.”
“Our field offices do their best,” he said, “but simply cannot provide the level of service the public expects from the Social Security Administration at recent levels of funding. Over the last few years as SSA offices lost staff, waiting times increased, lines grew longer and busy rates in our field offices deteriorated. Without sustained, adequate funding, this situation will only worsen. Furthermore, we must attack the disability backlogs, which have dramatically and unacceptably damaged many applicants’ lives.”
From his perspective, Mr. Allsup said government and the private sector have to work together to reach the solution.
“The disability backlog challenge is so immense that it will take an all-hands-on-deck approach to resolve,” Mr. Allsup said. “Government and industry must work together to meet the demands of the disabled today and in the future. We see the impact of the problem every day as we work with tens of thousands of disabled individuals and their families.
“There is no question the Social Security Administration needs more resources to meet this challenge,” the CEO said. “Companies like Allsup contribute by providing solutions in the marketplace-helping disabled Americans navigate-and reduce the time spent in-the SSDI process. It is important that citizens with disabilities know they have options available to assist them in their time of need.”
Having reached that time, Lynn Eddins would come to rely heavily on Allsup’s expertise. “I don’t really have a close family, and I’m a single woman,” she said. “So, I’m basically on my own.”
Cutting her ties to her employer also cast Ms. Eddins adrift from her healthcare coverage. For that, she would have to depend on an expensive COBRA plan. The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances. This includes voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce and other life events. Qualified persons might be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.
Her monthly premiums combined with co-pays and deductibles cost Ms. Eddins $15,000 per year out of pocket. She said she had no medical alternative because just one of her prescriptions costs $1,000 per month. Fortunately, she had a lot of equity in her house and opened the equity line of credit to help pay expenses until her SSDI was approved.
“At least I had equity in my house,” she said. “A lot of people out there don’t have it.”
Yet, even with Allsup’s help, the SSDI approval process was far from short and simple. Allsup representatives told her she might be declined once or twice along the way, which indeed she was, to her surprise.
“Social Security said I could sit at a desk and use my hands to earn $800 a month,” she recalled. “Well, hello! No, I can’t sit at a desk. It hurts when I sit. I wondered how these people could turn me down. They don’t know what I was going through.”
Looking back, she said, “I was foolish. I didn’t think at all that they could turn me down. Whew! I was wrong. At least I had a way to have money to live on.”
Ms. Eddins was grateful to Allsup for keeping in touch from start to finish. “They were very good about keeping me informed,” she said. “I always felt like they were on my side and working to get me approved. I really couldn’t ask for people more kind or considerate because I was going through a stressful situation. I’d call to say I didn’t want to bother them, and they just told me to call any time I wanted to. I felt really good about that.”
Before Ms. Eddins was turned down the first time, she said, “Allsup really prepared me. So, I wasn’t surprised. But it was the second time when I thought what more do they (the Social Security Administration) want?” She was also nearing the end of her COBRA coverage unless Social Security would relent and award her SSDI benefits.
The stress started to overwhelm her. “I had confidence in Allsup,” she said. “But then I saw stories on TV about people getting turned down and wondered if I was really going to get coverage. I began to lose hope and started to see a counselor.”
Amid her despair, she met Allsup representative Dennis Contreras who flew to Tucson for Ms. Eddins’ in-person hearing before an administrative law judge. Before the hearing Mr. Contreras made sure they had a letter in hand describing his client’s COBRA plight.
“We have a lot of success at Allsup,” he said, “and this particular judge is pretty fair.” Only 15 minutes into the hearing, the judge told Ms. Eddins she would be approved. “When that happens,” Mr. Contreras said, “it’s a very good day.”
Ms. Eddins received SSDI approval in February 2008, the climax of a 17-month journey that was still shorter than the typical approval process-if a claimant is approved at all.
“I honestly just wanted to get back what I paid into the system for many years,” she said. “If someone is entitled to a benefit and it is denied, there’s something wrong.”
She remains in contact with patients at the rehabilitation center and talks about Allsup with anyone who might need disability benefits. “I want to help someone else go though this,” she said, “because you really do feel alone – without an expert who can help.”
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