How the Administrative State Fails People With Disabilities

Debra Guckenheimer, a woman who lives in California, receives Social Security Disability Insurance (SSDI)—payments from a federal program in the United States for people with disabilities. The government doctor who examined Guckenheimer when she first applied for benefits, however, injured her and then denied her initial claim.

Unfortunately, according to a Center for American Progress report which describes what happened to Guckenheimer, her experience is not unique. The government imposes various burdens on people with disabilities who apply for government benefits, ranging from excessive paperwork to, in some cases, harmful medical exams.

In this report, Justin Schweitzer and several coauthors argue that these administrative burdens dehumanize and harm people with disabilities. They contend that such obstacles to social safety net programs add to what they term a disability tax, which is the notion that people with disabilities pay an extra cost to live and access resources. Federal and state governments must reduce the barriers to social safety net programs to ensure that people with disabilities can access the resources they need to live, argue Schweitzer and his coauthors.

SSDI helps over 7 million former workers with disabilities, over 1 million children of workers with disabilities, and about 100,000 spouses of workers with disabilities. Schweitzer and his coauthors describe SSDI as “a crucial lifeline for most recipients.”

To receive SSDI, applicants must complete what Schweitzer and his coauthors characterize as a “long, confusing, and laborious application process,” which can include disability documentation going back decades. The application includes five stages and the federal government can deny an applicant at any point. The process can take months or years, after which the federal government denies two-thirds of all applications.

Recipients can also earn limited wages while receiving SSDI benefits, Schweitzer and his coauthors note. They observe, however, that recipients must navigate the complex landscape of laws, rules, and regulations before pursuing such resources through “poorly structured and highly convoluted” programs. They say that Guckenheimer, for instance, mentioned the inconvenience of needing to hire a lawyer to navigate the SSDI system.

Schweitzer and his coauthors compare SSDI—the largest benefits program for people with disabilities—to Supplemental Security Income (SSI), the second-largest such benefits program. As of December 2021, SSI served over 6 million people with disabilities, about one in six of whom are children. SSI, like SSDI, also imposes “substantial” administrative burdens, Schweitzer and his coauthors argue. SSI requires, for example, applicants to complete an extensive application process with complicated legal requirements. In addition, between 2014 and 2016, SSI rejected over 20 percent of applicants due to technical errors and rejected about half of applicants for medical reasons. SSI awarded benefits to about 30 percent of applicants during that timeframe, which mirrors SSDI’s award rate.

Many of these administrative obstacles, Schweitzer and his coauthors contend, also burden program administrators. They argue that the burdens require administrators to deal with excessive paperwork and clerical errors, which in turn makes it harder for administrators to provide personalized assistance to applicants and recipients with disabilities.

Schweitzer and his coauthors suggest ways to lessen Social Security’s administrative burdens. They urge federal and state governments to abolish work requirements, which they note are ineffective. Furthermore, Schweitzer and his coauthors advocate the reduction of in-person interview, paperwork, and recertification requirements.

For SSDI in particular, Schweitzer and his coauthors recommend that the federal government permit applicants to use their own doctors during the application process instead of requiring applicants to use government doctors who often lack the necessary expertise to diagnose and treat patients’ specific disabilities.

Moreover, Schweitzer and his coauthors argue for the government to hire additional administrative law judges to clear the backlog of cases and eliminate the waiting periods for applicants to receive cash and Medicare benefits. In 2021, the average processing time for Social Security hearings took 326 days. Hiring additional judges would help the federal government resolve cases in under 270 days, according to Schweitzer and his coauthors.

In addition, Schweitzer and his coauthors discuss ways to help both disabled and nondisabled people apply for all assistance programs. They contend that federal agencies should increase response time requirements for beneficiaries and applicants and eliminate penalties for a lack of response to written notices. Moreover, Schweitzer and his coauthors maintain that federal and state governments should make transportation and housing more accessible and affordable to increase access to safety net programs. They also argue for a “no wrong door policy” which would create a universal application for all federal safety net programs.

Schweitzer and his coauthors say that their recommendations are only a start. To design programs that help people with disabilities, they urge governments to reach out and listen to applicants and recipients and then implement reforms that lift the burdens they experience.