Public InvestigatorTaking tips, chasing leads, exposing problems – 'It's just really, really bad'

A hospital social worker helped Nicholas Johnson fill out dozens of pages of paperwork for Social Security Disability Insurance in September after he woke up from a coma and realized he was paralyzed.

Johnson, 24, was one of 877 people shot in Milwaukee in 2022. He was in an argument with the mother of his daughter when the woman's boyfriend allegedly shot him four times.

One of the bullets went through Johnson's left arm, into his chest and hit his spinal cord. He can no longer walk or work at his job at Subway or as a part-time clothing designer.

Johnson missed two phone calls from the Social Security office while he was in physical therapy. He started the application process over, for a third time, in early January.

With no income, Johnson can't pay rent, so he moved in with his grandmother. But her home is too small to accommodate his wheelchair, so family members come over daily to carry him from room to room.

"If I didn't have my grandmother, I would be homeless," Johnson said.

Johnson is one of more than 2,000 people in Milwaukee waiting for the Social Security Administration's approval to receive disability benefits, according to the latest data available from the agency. The average wait time is 368 days, leaving many people struggling without adequate housing or money to pay for their basic needs for more than a year.

In Madison, more than 1,000 people are waiting. Their average wait time is 310 days. Statewide, it takes an average of 227 days — up from 90 days in 2019 — for people to receive their first disability check.

Pandemic creates

Social Security gridlock

The pandemic has caused gridlock for people trying to obtain Social Security benefits. An investigation by the Washington Post found filings across the country have jumped nearly 60% since the pandemic.

It's a situation similar to the long wait times Wisconsinites experienced in 2020 with the state Department of Workforce Development's processing of unemployment benefits. Only this time, the state's most vulnerable population is at risk.

Americans are getting older and sicker at the same time a wave of retirements and resignations hit national and local Social Security offices, creating a perfect storm for the federal agency that people have depended on since the 1930s.

Maeve Pirt Meyer, an attorney with Madison-based Haskins Short & Brindley who focuses on Social Security disability law, said many of her clients end up homeless while waiting for their disability benefits. Some live in cars or on friends' couches.

"Those folks are supposed to have expedited processing, but I don't think it is any faster these days and I don't think it has been for a while," said Pirt Meyer, who is not Johnson's attorney.

Doug Nguyen, a spokesman for the Social Security Administration, said the agency is taking a "comprehensive, multi-pronged approach" to reduce the backlog of disability cases that developed during the pandemic.

"This strategy includes immediate action using specialized teams of current and recently retired SSA employees with disability experience to assist the state disability determination services (DDS) in processing cases, a hiring surge to address attrition among state disability examiners, and a comprehensive assessment of the disability process," Nguyen said in a written statement.

'Like a Geico policy'

About 80% of claims are denied during the first review and it's closer to a 90% denial rate on the second review before the case goes to a hearing, where it has the most likely chance of being approved, Prit Meyer said.

"That's why I describe (disability claims) like a Geico policy," Pirt Meyer said. "We're all paying for the policy, but they're not going to automatically give you the payment. You still have to meet the qualifications of the claim, and that's a big shock to people."

In order to qualify for Social Security Disability Insurance, people must prove they are "insured," meaning they've worked long enough and paid Social Security taxes.

They then must prove they have a medical condition that meets the government's strict definition of a disability. They must also go through a five-step evaluation that includes proving they haven't been able to work for a year and that they are unable to go back to any of the jobs they have held in the last 15 years.

Hope Lloyd is a community living and home supervisor with Independence First who is working with about a dozen people in Milwaukee with spinal cord injuries who haven't been able to get their first disability checks, so they are living in nursing homes or with family.

"It's not where they belong, but without those expedited payments, they can't apply for an apartment because they don't have any income," Lloyd said. "A lot of times, they're the primary breadwinner, so it's just really, really bad."

Once those disability checks finally arrive, finding safe, affordable housing is also a struggle.

More than 4,000 Milwaukee families with disabilities are on a waiting list for public housing, said Amy Hall, a spokeswoman with the City of Milwaukee Housing Authority. Another 2,000 families with disabilities are on the waiting list for the housing choice voucher rental assistance program, Hall said.

While thousands of people in Wisconsin are waiting for their benefits, others are being kicked out of the system.

Raquella Freeman got a notice from the Social Security Administration in June that the disability benefits she had been receiving since she was 18 were under review. By November, the agency decided Freeman was no longer disabled enough to get the $600 per month stipend she was using to pay her rent and buy groceries.

Freeman, 30, was born with cerebral palsy and applied for the benefits while she was in college so she didn't have to completely depend on her parents. Now she's in graduate school at Marquette University and working part time at Independence First in Milwaukee.

But a person's earnings have to be less than $1,470 a month — or $17,640 a year — in order to be considered to have a qualifying disability. And they're not allowed to have more than $2,000 in a savings account. Freeman's salary from Independence First put her just over the $1,470 a-month threshold.

"They don't want you to have money, they don't want you to save money, they just want you to exist," Freeman said. "The system was designed to help people get out of institutions and into the community, but right now, it's not benefiting anyone. It's encouraging people not to work, because they're scared to lose their benefits."

An unprecedented wave of resignations

Nguyen, from the Social Security Administration, said the agency is analyzing the factors that have contributed to the backlog including the loss of about 20% of disability examiners, a shortage of medical experts to review cases and increasing medical evidence that must be reviewed.

At the state level, the Wisconsin Department of Health Services said a mandated federal update to its computer system in late 2019 further pushed wait times.

"Wisconsin's legacy system was superior to the current (federal) system because it included more automatic prompts for examiners that made it easier for them to manage their very high caseloads," said Jennifer Miller, a spokeswoman with DHS.

Miller said examiners receive specialized training that takes more than two years to become fully proficient.

"As a result of increased evidence, increased scrutiny, continuously growing case complexity, and a new nationwide case processing system rollout, case production has become more labor-intensive and slower," Miller said. "Adjudicators' case counts have increased significantly, and the job has become untenable in many states."

This month, the Social Security Administration approved a pay increase for examiners, Miller said. DHS is hoping that will help with recruitment and retainment.

After graduating from UW-Madison in 2018, Logan Mrozenski took a job as a disability examiner at the Wisconsin Disability Determination Bureau hoping to help people applying for federal aid. He was paid about $20 an hour.

After three months of training and a year of supervised probation, Mrozenski was given a full caseload of about 100 cases with the expectation that he would clear 10 cases a week. Mrozenski said the work was stressful and he soon found the process of having to turn down more than half of the applicants disheartening.

Mrozenski left the bureau in November 2020 and returned to school for nursing.

"I wanted to help people in a more direct way," Mrozenski said. "When you look at this job, you think you are helping, but when you look at the program, and how much aid people get, the rules, how long it takes, that's where it is really discouraging."

Freeman, who has taken on additional work at Independence First so she can pay her bills, said she's relieved to be out from the stress of the Social Security Administration.

"The science behind it makes no sense," Freeman said. "It needs to be changed — not necessarily for people like me, but so people can work and they don't have to live in poverty. It creates a forever cycle of poverty that people are penalized for trying to get out of."

About Public Investigator

Government corruption. Corporate wrongdoing. Consumer complaints. Medical scams. Public Investigator is a new initiative of the Milwaukee Journal Sentinel and its sister newsrooms across Wisconsin. Our team wants to hear your tips, chase the leads and uncover the truth. We'll investigate anywhere in Wisconsin. Send your tips to [email protected] or Signal at 414-319-9061. You can also submit tips at jsonline.com/tips.