First of two parts
Kelly Page was a happy, hard-working North Buffalo woman when a brain aneurysm and a stroke rocked her world.
It was spring in 2016 when her family began to notice that Page, 41, was forgetting things.
She had trouble remembering life’s little details – like what time she was supposed to pick up her son from school, or something her boss had told her to do at the Amherst jewelry business where she worked as an administrative assistant.
Months later came painful headaches. An MRI exam revealed that she had suffered a brain aneurysm.
The neurologist advised her to have surgery to repair nerve damage in her brain.
Doctors told her that her chances of having a stroke during the procedure were about 3%. But when she had the surgery on Aug. 2, 2017, she suffered a stroke.
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“I went to see her in the hospital the next morning, and she didn’t know who I was,” recalled her husband, Keith Page. “After a few days, she recovered a lot of her memories … but really, she’s never been the same since.”
Two doctors advised Page that – because of the brain injuries – she was no longer capable of working. On Jan. 30, 2018, she applied for Social Security disability benefits.
She and her husband have been fighting with the federal government ever since.
Kelly Page is one of more than a million people who are trying to obtain disability benefits from the Social Security Administration. Although working Americans pay a portion of every paycheck into the nation’s disability system, getting disability benefits is no simple matter for those who are sick or injured.
For many applicants, the process is complicated, confusing and frustrating, often taking years to get a final answer from the government.
Many ailing Americans go into bankruptcy and more than 9,000 a year die while waiting for the Social Security Administration to decide on their disability claims, according to the Government Accountability Office.
Those who are successful in the process get payments averaging $1,400 a month.
“We could really use disability. We were a two-income household; now we’re down to one,” said Keith Page. “Losing Kelly’s salary cost us $38,000 year. We wouldn’t be getting by without the donations we got from family and friends.”
In June 2018, Page’s first application for disability was turned down. The SSA told her she had not proven that she was unable to work. Page filed an appeal.
On Nov. 15, 2019, an administrative law judge determined that Page was 100% disabled and unable to work. The SSA awarded Page $1,683 a month in disability pay.
But in January 2020, the SSA Appeals Council told the Pages it had randomly picked Kelly’s case to be re-examined.
She was required to participate in a new hearing before a different judge. Last August, the second judge ruled that Page never was disabled in the first place.
The SSA stopped the benefits that Page had been receiving.
In April of this year, the Pages and their Buffalo attorney, Christopher Grover, filed an appeal in federal court.
“If we’re fortunate, a federal judge will find in our favor and send the case back to Social Security to take another look,” Keith Page said. “In other words, even if we win, we’ll probably go back to square one.”
“I have paid into disability my entire working life, every paycheck,” Kelly Page said. “But the the government acts like they think I’m some kind of scam artist … a criminal.”
“I loved my job. I would rather work. I can’t,” said Page, who speaks haltingly, and according to her husband, has moments of confusion and anxiety.
Kelly Page looks through documents from her disability case at her North Buffalo home.
Grover and many other attorneys who represent disability claimants accuse the Social Security Administration – or SSA – of making the process exceedingly difficult for claimants.
Because of some high-profile disability fraud cases, the government has become skeptical of many applicants, Grover said. One current judge and one retired judge from the SSA agreed with Grover during recent interviews with The News.
Some of the people who file claims, indeed, are scam artists, like Eric Conn, a lawyer from Kentucky who went to prison in 2018 after federal agents found he paid off a judge and some doctors to push through disability cases for his clients. Prosecutors said Conn’s corrupt operations cost taxpayers $550 million.
Program costs billions
Meanwhile, those who worry about runaway government spending say the SSA really should be careful about who qualifies for disability, especially during a time when the federal government is $32 trillion in debt.
They note that Social Security Trust Funds – depended upon by hundreds of millions of Americans – are being depleted.
The amount of taxpayer money spent annually on disability benefits has risen from $77 billion in 2003 to $142 billion in 2022.
The agency’s Buffalo office is one of 168 hearing offices. The office has eight judges who hear disability cases.
Most applicants – 65% nationwide and 60% in New York State – get turned down on their first application for disability benefits, according to government statistics.
Of those who then decide to hire attorneys and appeal their cases before an SSA judge, 54% nationwide get approved. In Buffalo, a lower number – 48% – get approved by judges.
The SSA has been long criticized for the long waiting times for disability applicants, some of them desperately ill.
In 2007, it took an average of 688 days – more than 22 months – to process a disability claim in Buffalo. At that time, that made Buffalo the seventh-worst office in the nation, in terms of processing times.
Since then, the wait times have improved in Buffalo and nationwide, but the average claimant in Buffalo still waits an average of 553 days – roughly 18 months – for a final decision.
SSA officials told The News they have worked hard to reduce the number of people waiting for hearings. They said that number has gone down from more than 850,000 in 2018 to less than 339,000 now.
The quest for disability benefits has been arduous for Leah Biggins Charache of Rochester, a former Army combat nurse who served in the Middle East after the terrorist attacks of Sept. 11, 2001.
She suffers from post traumatic stress disorder, which was aggravated by the death of an infant son in 2013, and has been classified as 100% disabled by Veterans Affairs doctors. But the SSA has been disputing her claim for disability benefits since 2014.
“It’s very frustrating. They keep telling me I should be able to work, no matter what the VA says,” Charache, 39, told The News.
Kristi Curran of Lancaster spoke of her difficulties with the SSA in the case of her late ex-husband, Michael J. Curran Jr., a retired state trooper who died in 2021.
Curran, a father of three, slipped on ice and suffered a traumatic brain injury in 2016. He was in a coma for three months and spent the rest of his life in nursing homes, unable to care for himself.
The SSA awarded him disability benefits, but took the benefits away in 2019, after a mistake was made on a tax return, saying that Curran was still working.
“The guy was absolutely not able to work. He was in a nursing home. A simple clerical error was made on a tax return,” said Abbott, attorney for the Currans. “We gave the SSA all the paperwork explaining the mistake … but still, they fought us for years before reinstating his benefits.”
Charache, like Page, said she feels like the government suspects her of being a scam artist.
“I do think some legitimate claimants have been hurt by some of the efforts to crack down on fraud, after the Eric Conn case,” said Som Ramrup, president of the American Association of Administrative Law Judges.
Ramrup said she believes the actual amount of fraud in the applications “is infinitesimal.”
“The government acts as though the amount of fraud is much higher,” Ramrup said.
Michael J. Astrue, who headed the SSA under President George W. Bush, told The News he believes “less than 1%” of disability claims are fraudulent.
When asked by The News on June 29 to estimate the percentage of claims that are fraudulent, current SSA officials did not respond.
The agency still has not responded to most of 15 questions about disability asked by The News on June 29.
The SSA has said in the past that it works hard to be fair to all disability claimants, and that it has been trying for years to shorten the waiting time for claimants.
In a brief statement sent to The News Friday evening, the agency said: Administrative law judges “accept their positions knowing they are responsible for providing quality hearings and decisions in a high-volume caseload environment. A quality decision is factually accurate, procedurally adequate, policy compliant, timely issued, and supported by the evidence. ALJs have qualified decisional independence, which means they make decisions free from pressure to decide cases a certain way.”
Several Buffalo attorneys said the agency sometimes makes decisions that seem to be at odds with the facts of a case, making the process stressful for many disability claimants.
“You have people who are already sick and under a lot of stress when they apply for disability,” said Kenmore attorney Richard G. Abbott. “Some of these people have to fight the system for years before they are finally granted disability, and that process can be very stressful.”
According to Abbott, Jeffrey Freedman and other Buffalo disability attorneys, there seems to be little logic behind some of the government’s decisions to turn down claims.
“I had one client who lost both his feet in an industrial accident,” Abbott recalled. “Social Security turned him down on his first application. He had to fight to get his disability.”
A former insider speaks
“The deck is stacked against” disability claimants, according to Spencer Bishins, a former SSA insider who said the government agency punishes judges who tend to approve large numbers of disability claims.
Bishins is a lawyer who spent 11 years working for the SSA. He said he helped judges to write nearly 2,000 decisions on disability claims.
He also worked on the SSA Appeals Council, reviewing judges’ decisions for mistakes. Bishins now works as a disability rights lawyer in Tacoma, Wash., and he wrote a book called “Social Security Disability Revealed.”
According to Bishins, the SSA prefers judges “who deny a high percentage of cases,” while often conducting reviews of judges who most often find in favor of disability applicants.
“Judges who pay large numbers of cases are sometimes sent for counseling,” said Marilyn J. Zahm, a retired SSA judge from Buffalo. “I never saw a judge sent for counseling for turning down too many applicants.”
SSA officials denied that judges are pressured in any way on how to decide cases.
Among the nation’s 1,250 SSA judges, there is a huge disparity in approval rates. The latest available government study showed that one judge approved 97% of disability claims, while another approved 10%.
Both Rom and Zahm told The News that judges are “rushed” by the SSA to turn out decisions – with a goal of completing 500 to 600 cases a year.
They said some cases are extremely complex, requiring a judge to examine hundreds of pages of detailed medical reports, with different medical and vocational experts offering conflicting opinions.
“On average, including the hearing, we get two to three hours to research a case,” Rom said. “For some cases, that is just not enough.”
A judge only needs one piece of evidence from one medical expert to justify his or her ruling, even in cases where there are sharp disagreements between experts, said attorney David Camp.
Kelly Page has been trying to get benefits since she suffered a brain aneurysm in 2016 and a stroke in 2017.
$890,000 paid to medical expert
In Kelly Page’s second hearing, 11 medical experts, one physical therapist and one vocational expert testified about her health and capability to work.
Judge Stephen Cordovani’s ruling gave the most weight to the written report of Dr. Steven Goldstein, a neurologist from Houston who has a long and lucrative history as an expert witness paid by the SSA.
Goldstein, who never met or interviewed Kelly Page, reviewed her medical records and voiced the opinion that she can return to work.
The judge said he found Goldstein’s opinion “persuasive.” But the opinion of a Buffalo doctor, who treated Page for years, examined her repeatedly and concluded that she cannot work, was found to be “not persuasive.”
Because of a rule change enacted by SSA in 2017, judges no longer have to explain in their decision why they are adopting one medical expert’s position while ignoring others.
“Before that, the judges had to articulate in writing their reasoning for giving more weight to one doctor’s opinion,” said Camp, who is chief policy officer for the National Association of Social Security Claimants Representatives.
Speaking of medical experts hired by the SSA to review cases, Camp said some experts are very good while some are “disturbingly bad.”
“I’ve seen reports from paid medical experts that looked like they were mass produced, like somebody just hit a button on a computer,” Camp said.
A News reporter tried five times to reach Goldstein, who runs a medical practice in Houston in addition to his work as an SSA medical expert. “He told me to tell you he is not interested in speaking with you,” his assistant said after the fifth attempt.
According to government records, Goldstein was paid $890,250 by the SSA to consult on cases between 2010 and 2018, an average of $98,000 a year. The agency paid Goldstein $213,850 in 2018.
When The News asked for further details about the SSA’s dealings with medical experts, including the total amount of money Goldstein has received from the agency, the SSA did not respond.
<&rdpEm>Coming Monday: How scam artists make it harder for legitimately ill people to get federal disability benefits.</&rdpEm>
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