Disabled persons in North Carolina have never had it easy, but recently it has become even more difficult to get a disability claim processed. Consider the current state of North Carolina social security disability claims:

• There is a backlog of over 27,000 Social Security disability cases awaiting decisions in North Carolina.
• 60 percent of initial applications in NC are denied.
• Two-thirds of NC application rejection decisions are based on the opinion that the client actually can perform work.
• However, when administrative law judges review denied NC social security disability cases on appeal, about 70 percent of them are later approved.

An indicator of the increased difficulty of gaining North Carolina Social Security benefits is the decreasing number of cases that are approved when compared to the growing number of applications. Between 1999 and 2003 the number of applications for disability benefits almost doubled while the number of awards decreased by 50,000. In 1999, 707,169 people had their applications approved for benefits, while in 2003 only 651,002 had applications approved.

According to Rick Fleming, Social Security disability attorney at the Law Offices of James Scott Farrin, the average individual benefit per month does not usually exceed $900. Why, then, is the door closing on benefits in a program that Fleming calls “a safety net, not a gravy train?”

One important reason may be due to the paring down of federal funding for the program. In 2008 both the Social Security Administration (SSA) and the state agency that makes medical disability determinations on behalf of the SSA, the Disability Determination Service (DDS) will face staffing decreases that may force to scale back employee hours. It has been suggested that the funding cut could double the national backlog of Social Security disability cases pending decision from 700,000 to 1.4 million.

Another reason it is difficult to get a disability claim approved is the apparent difference between adjudication at DDS compared to adjudication at the hearing level before a judge.

The people at DDS just are not equipped to look at nuance or even odd combinations of qualifying data, according to Fleming. One approach for a personal injury attorney working with social security disability clients is to look for multiple disability qualifications for an individual who does not clearly qualify for benefits under one disability. Such an approach may help a disabled person secure benefits that will give them the safety net promised by the Social Security insurance system in the first place.

“The kind of case that gets turned down over and over by DDS is a complex one that may require them to put together several disabilities,” Fleming explained. “For example, a person 35 years old with an IQ of 70 or less who has a torn rotator cuff and can’t work as usual without pain; this is the kind of social security disability case that could wait nearly three years for a resolution.”

Add to this the fact that the process for being denied is less rigorous than it is for being approved for benefits and the failure rate of applications begins to make more sense. The DDS process makes approval more cumbersome than denial.

“Denials are generally in and out,” says Fleming, “whereas approvals frequently require shipment to the SSA Regional commissioner’s office in Atlanta for a ‘Quality Review’ approval which, in essence, is a scrutiny of the approval decision made by DDS. This adds to the time it takes to process an approval. In simple terms, it makes it harder, or at least more daunting, to approve a claim.”

Sources: Fred Kelly, “Delays Plague Disability,” Charlotte Observer, February 14, 2007; Annual Statistical Report on the Social Security Disability Insurance Program, “Outcomes of Applications for Disability Benefits,” 2004, accessed February 27, 2007.