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The Social Security Administration has been struggling to pull off a balancing act. Since the recession, there's been a surge in the number of people applying for disability benefits. At the same time, the money the administration gets to handle claims has been shrinking. The agency recently updated its application process. And some say this could make getting benefits even harder.
Alex Smith from KCUR in Missouri has our story.
ALEX SMITH, BYLINE: By the time Stephanie Hashmi was in her mid-20s, she had achieved a lifelong dream. She was the charge nurse of one of Kansas City's largest intensive care units. But even as she cared for patients, she realized something was off with her own health.
STEPHANIE HASHMI: I remember just feeling tired and feeling just sick and hurting and not knowing why my joints and body was hurting.
SMITH: Hashmi was diagnosed with systemic lupus, a disease in which the body's immune system attacks its own tissues and organs. She's had surgeries and treatments, but now at age 41, Hashmi is often bedridden. She finally had to leave her job about six years ago. But when she applied for disability benefits, she was denied.
HASHMI: I just started bawling. If they looked at my records or read these notes, surely they would understand my situation.
LISA EKMAN: It is not easy to get disability benefits. And it's a very complicated and difficult process.
SMITH: Lisa Ekman is with the National Organization of Social Security Claimants' Representatives. Right now, just about 45 percent of people who apply for disability benefits are ultimately accepted. And getting a hearing takes an average of nearly 600 days. The backlog started snowballing about 10 years ago, around the time Jason Fichtner became acting deputy commissioner of the Social Security Administration.
He says during the recession, a lot of people applied who had disabilities but weren't necessarily unable to work.
JASON FICHTNER: But they're on the margin. They can work, but when a recession happens, those are the first people who tend to lose their jobs. And then they apply for disability insurance.
SMITH: Fichtner is with George Mason University. There are now more than a million people across the country waiting for hearings. Adding to the strain, the administration's core operating budget has shrunk by 10 percent since 2010. This spring, the Social Security Administration introduced changes to fight fraud and streamline the application process, including a new rule that removes special consideration given to a person's longtime doctor.
This is to weed out the admittedly rare cases of treating physicians tipping the scales for their patients. But Lisa Ekman says excluding a person's doctor is a mistake.
EKMAN: Those changes would now put the evidence from a treating physician on the same weight as evidence from a medical consultant employed to do a one-time brief examination of an individual or a review of the paper file and may never have examined the individual.
SMITH: She says this could lead to more denials for disabled people with complex conditions like lupus, multiple sclerosis or schizophrenia. These illnesses can affect patients in very different ways and may be hard for an unfamiliar doctor or nurse to evaluate. She says more denials will lead to more appeals, which will increase the backlog.
But former administrator Fichtner says the agency is obligated to weed out all fraud it can. And the administration can still prioritize applicants.
FICHTNER: For patients who are really in dire condition and really have major disabilities, I don't think they have to worry about this rule change.
SMITH: He acknowledges the backlog needs attention and says the agency has safeguards to monitor whether the rule is working. After several rejections, Stephanie Hashmi is increasingly pessimistic. But she's continuing to fight. Her next hearing is scheduled for November of 2018. For NPR News, I'm Alex Smith in Kansas City.
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