RICHMOND, Va – People from Virginia and beyond say they're struggling to navigate a system meant to help those unable to work. They're applying for disability benefits through the Social Security Administration (SSA), but their claims are getting stuck in what feels like limbo.
"It's just a waiting game now. So I'm just like, how long are we supposed to wait?" Tammie Tyler, A Virginian handling the application process for her disabled brother, told CBS 6 investigative reporter Tyler Layne.
It's not just Virginians facing delays.
"Your case is pending, your case is pending. No updates, no nothing. It's completely frustrating," said James Moore from Massachusetts.
"They're delaying at every turn in every way, shape, form and fashion possible," said Jon Bailey from North Carolina.
While they wait, financial hardships are multiplying.
"I've lost everything I've owned. I've lost my truck. I've lost my motorcycle. I have no transportation," said Jeffrey Silverman from Utah.
And for some, their mental health is plummeting.
"Sometimes it's like, what do I even wake up for? Just to feel miserable and know that I have nothing?" said Lisa Harris from Virginia.
After CBS 6 shared the stories of three Richmond-area men who struggled for years to get their benefits, our newsroom was inundated with concerns from claimants across the country.
We interviewed several of them and asked each claimant to share information and documentation about their case.
"I thought maybe if there were other people that said, 'Hey, you're not in the fight alone,' that there are other people who are going through the same struggles, that maybe our voices could be heard," Tammie Tyler said.
How long a person waits for an answer to their claim can depend on where they live
While the SSA is a federal agency, it tasks state agencies which are federally funded to review and process disability claims. Therefore, each state can have varying processing times.
SSA Commissioner Martin O'Malley has acknowledged that state agencies are backlogged and understaffed, which he said is the result of persistent underfunding from Congress.
In Virginia, data in 2023 showed it took 228 days on average for a determination to be made on an initial claim, which was slightly above the national average. Overall, initial claim processing times last year were the longest ever in the history of the program.
In this phase, approvals were granted 42% of the time in Virginia.
"It's become a game to me at this point to see if I actually get an answer from someone that will be able to help me find out what the status is, and I've been told it could be a year from now," Tammie Tyler said.
For the majority of applicants who are denied at the initial stage, they have the option to pursue an appeal, which will extend the timeline much further.
The first appeal is requesting a reconsideration, which means the same state agency that denied the initial claim will give the case a second look and may consider additional documentation.
In Virginia last year, reconsideration requests were approved 17% of the time. The low award rate has led some disability advocates and attorneys to call for this stage of the process to be eliminated completely.
On average, reconsideration decisions took an additional 221 days in Virginia.
"It's mentally draining, emotionally draining too," Lisa Harris said about her mental state as she waited for a reconsideration determination.
Lowell Murray, a Virginia claimant, said it only took his determination office three days to deny his reconsideration request, which included more than 800 pages of submitted paperwork.
"I don't know what they looked at, if they just kept swiping just to kind of get through it or what. I'm not sure," Murray said.
If the reconsideration request is denied, the next step is to appeal to an administrative law judge. At this stage, an independent judge will thoroughly review cases.
At this step, claims were approved nationally 45% of the time last year.
Experts and attorneys believe approval rates are higher in this stage because the judges spend more time with the cases and hear testimony directly from claimants and their attorneys.
The chances of approval also differ by judge. For example, data shows two judges in Richmond have made just about the same number of total decisions. But one judge's decisions were fully or partially favorable to the claimant 52% of the time while another judge's decisions were favorable 23% of the time.
In Richmond, a claimant will add an extra 11 months to the total process just waiting for their hearing date. And last year, it took 450 days on average to receive a hearing decision.
Richmond's hearing office makes 1.37 decisions per day, one of the lowest numbers in the nation. Richmond's office was ranked 135 out of 162 offices nationwide.
Lowell Murray said he's currently waiting for a hearing and has now involved an attorney.
"I honestly never thought this was going to take this long, but it grates on you," Murray said.
If the appeal to an administrative law judge is unsuccessful, a customer's next step is to take the case to the SSA's appeals council review.
Here, just 1% of cases were approved and 13% of cases were remanded to the administrative law judge for further review last year.
CBS 6 could not find updated publicly available data for processing times at this stage, and the SSA's press office has not yet answered questions sent on August 20 requesting that information.
The most recent publicly available processing time data for an appeals council review decision was from 2016, and at that time, it was 364 days.
James Moore, in Massachusetts, said he escalated his case to the appeals council review after being denied by an administrative law judge.
"From what I heard, that takes between 15 and 18 months, which is completely unacceptable on my part, because I can't afford to live that long without job," Moore said.
If that appeal fails, the last option is to sue in federal court.
Nationally, nearly a quarter of appealable cases resulted in this action last year, the highest percentage since 2010.
At this stage, federal judges sent six out of ten cases back to the SSA for further action, meaning there could have been a decisional error somewhere in the process or new documentation for consideration was presented.
The SSA's press office has not yet answered questions sent August 20 requesting the percentage of cases remanded by federal judges that resulted in awards for claimants.
In total, a person who makes their way through each stage of the process could spend multiple years waiting for benefits.
A 2020 report by the investigative arm of Congress found, "for some applicants, a long wait time may have increased the potential risk of declining health or death prior to receiving a final benefits decision."
The claimants who spoke to CBS 6 said they felt dismissed by a system their taxes support.
"It's really disappointing, because I have paid into this system my whole life. I've always believed in it," Jeffrey Silverman said.
And they're calling on their federal leaders and lawmakers to address their concerns with urgency.
"They need to find a sustainable measure to help people who really need the help," Tammie Tyler said.
The SSA's plan to improve wait times includes hiring 400 additional disability determination examiners nationwide, upgrading technology used to review cases, and encouraging more customers to seek assistance online.
The agency has also updated administrative policies in an effort to streamline its services and parts of the application process.
An SSA spokesperson told CBS 6 they could not comment on any of the cases featured in this story due to privacy laws but that the agency would reach out to each claimant individually.
After our interviews, CBS 6 was made aware of at least two customers who have now been approved for benefits.
James Moore said his claim was approved at the appeals council review stage, after waiting a year and eight months.
Tammie Tyler said her brother's initial claim was approved, after waiting nine months, but has not yet received any payments.
Others continue to wait with a sense of uncertainty.
"I don't want to live every day thinking, how in the world are you going to make ends meet if you can't get help?" Lisa Harris said.
Watch Tyler Layne's reporting on CBS 6 and WTVR.com. Have something for Tyler to investigate? Email him.
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