Delayed & denied: How Social Security leaves gun violence survivors behind

For more than 25 years, Clark James made his living as a truck driver. The 45-year old father of three, whom we’ve assigned a pseudonym because his Social Security case is ongoing, earned $46,000 in his last year of work. But that all changed last summer.

One evening, James was hanging out with friends in North Carolina when gunfire suddenly broke out. One of the bullets tore through his stomach and exited out of his back, where he had undergone spinal surgery a few years before.

Since his injury, James has been unable to sit down for long periods of time without pain.

“After getting shot where I got shot at, and with the bullet exiting where it exited at, my body, my back, is never going to feel the same,” he said.

Unable to return to work, James decided to apply for Social Security disability benefits. But his initial application was recently denied because the Social Security Administration (SSA) said they had determined he would be able to adjust to other work. The decision left him frustrated and confused.

“They put you through so much [during] the process, and then you’re waiting all this time to receive a no,” he said. “It’s just been a real burden on me, because I’m here, waiting for assistance, hoping I can get assistance, and it’s been six, seven, eight months now waiting around…I don’t get it, and [now] I’m back to square one, don’t know what to do.”

James is currently appealing the decision, but for now, he and his family are relying on his wife’s income of about $40,000 per year. James’ experience aligns with that of many Social Security disability applicants injured by gun violence.

“It’s a lengthy process. Sometimes it takes months and months for some people. You really have to have support to be able to go through the process…And sometimes you have to do the application more than once,” said Tiffany Lamela, co-executive director of Life Camp, a violence prevention organization based in Queens.

Our first article in this series highlighted the difficulties people face in returning to work or accessing temporary financial assistance programs after a firearm injury. For gun violence survivors who have severe physical or mental disabilities, or have exhausted temporary benefits, the process for securing long-term financial assistance can be even more demanding. And even those who are awarded benefits can still struggle financially.

Social Security disability explained

Permanently disabled workers in the United States can apply to two federal programs administered by the SSA.

The first is Social Security Disability Insurance (SSDI), an insurance program that provides benefits to disabled workers who have paid into the system as an employee. Typically, a person must have worked for five of the last 10 years to qualify. The program also prohibits people from receiving benefits who have been injured in the commission of a felony.

Carolyn Dixon, who works with victims of gun violence through Life Camp, explained that many of the gun violence survivors they have assisted do not qualify for SSDI because they have not been traditionally employed.

“The only thing that these survivors who are not working or have no work history [can do] is apply for SSI,” she said.

SSI, or Supplemental Security Income, is a needs-based program designed for disabled people who have very low income and few assets. People typically receive higher monthly payments from SSDI than SSI. Some, like James, are eligible and can apply for both.

What the two programs have in common is their strict disability requirement, which is among the most stringent of any Organisation for Economic Co-operation and Development (OECD) country. To qualify, the SSA must deem the applicant unable to do any type of full-time work for at least one year.

“It’s all or nothing,” said Na Yin, a professor at Baruch College and co-director of the New York Retirement and Disability Research Center. “You get accepted if the work limitation you have is deemed as very, very, very, severe and results in permanent [disability] or death, or [SSA determines] you have no disability at all, so your application is rejected. In contrast, Sweden and many other Nordic and other OECD countries—their disability system recognizes partial disability.”

“There’s always the assumption that there is some sort of sit-down work that can be done that could accommodate the limitations that a person has,” said Ashley Sappenfield, a Social Security disability attorney in North Carolina who has represented gun violence survivors.

“A person that got paralyzed…is always going to have a higher success rate because their injury would probably eliminate sedentary work. Otherwise, it’s much more difficult.”

The statistics bear this out. In 2022, only 38% of applicants were approved in the initial application stage. A 2023 Washington Post investigation also found that judges who review decisions in a later round have faced pressure from the SSA to issue more denials.

“It does almost seem like [Social Security] is trying to find reasons to deny people, or pay less money, based on these statistics of how so many people get denied,” said Shivam Patel, a Social Security disability attorney in New York City who has also represented survivors of gun violence.

He said this approach can result in people being left without support that they truly need.

“People often feel kind of wronged or betrayed,” he said of the grueling process. “‘If this is my money, [they ask], why does Social Security make it so difficult to get that when I need it especially?’”

The challenges of applying for benefits

The first hurdle in the Social Security process is gathering the necessary paperwork, including proof of identity, employment documents, and medical records.

“Paperwork is hard for anybody, but if you just went through this physical trauma…even just physically filling out paperwork can be hard for people if you don’t have somebody else to do it,” said Chris Hilderbrant, executive director of the Rochester Spinal Association, an organization that supports people with spinal cord injuries.

While the SSDI application can be completed online, the SSI application is paper-only. This places a further burden on applicants, many of whom face steep financial challenges.

“A lot [of applicants] are unhoused, or in unstable housing situations,” said Laura Beth Waller, a Social Security disability attorney and chief strategy officer at the National Organization of Social Security Claimants’ Representatives (NOSSCR). “[They] may not have reliable access to a telephone or [the] internet, and may not have ready access to the amount of paperwork that you need to file an SSI application. Gathering all of those things—some of your stuff may be at a family member’s house, but you’re staying at a friend’s house or in a shelter—can be really onerous and burdensome.”

Even after collecting all the needed documents, there are still barriers: “Having to haul all that stuff into a field office, make an appointment at a field office…it just places a really high level of burden on a person who is mentally or physically disabled,” Waller added.

Patel also said some of his clients have had negative experiences at SSA field offices.

“I come across a lot of people who tried to file for the disability benefits on their own, or they went down to a Social Security [office] to get answers to things, and people often treated them very rudely. They might not actually help them out [or] tell them, ‘You need to fill out these forms,’ or ‘This is what you need to do,’” he said.

Another difficulty with the Social Security process is long wait times. The national average wait time for the initial application is currently around seven and a half months. Those denied in the first round—a majority of applicants—must enter an appeals process that can involve multiple additional reviews, adding months or even years to the process. On average, it takes applicants almost two years to receive a final decision.

“They need to speed this process up,” James said. “You can’t have people waiting like this. Livelihoods are on the line, bills are coming like clockwork.”

The wait times are especially difficult because applicants must also remain under the “substantial gainful activity” threshold that the SSA uses to help determine whether an applicant is disabled. In 2024, applicants who are working and earning more than $1,550 per month do not qualify for benefits.

“Let’s say you are a person that’s the sole provider for your family and you’ve had this injury. You’re going to run into some unique challenges on what to do. That’s often why people return to work—because they don’t have any other option,” Sappenfield said.

This financial pressure can also push people back into the dangerous activities that led to their injury.

“We had a couple guys who, when they went into the hospital, they had been involved in selling drugs…and they [wanted] to get out of that. But when they’re discharged, they have no income. So how are you going to pay for anything? Food, rent, [et cetera]. It really sets people up to return to a lifestyle they might not want to be part of,” Hilderbrant said.

The SSA has set a goal of cutting down these wait times under their recently appointed Commissioner Martin O’Malley.

“As an agency, we are taking steps to reduce our average initial disability processing time for customers,” spokesperson Ann Clifton wrote in a statement.

These efforts have included simplifying aspects of the disability evaluation process, and requesting greater appropriations from Congress to allow for faster processing times.

Since 2010, administrative funding for SSA has declined, with the customer service budget decreasing by 19% and staff by 11%, while the number of disability recipients has risen by 25%.

Waller agreed that the SSA requires more funding so they can hire more staff.

“The appropriations just haven’t kept pace with what Social Security needs to fund technology and staffing,” she said.

The NOSSCR is also advocating for a more significant action: eliminating “Reconsideration,” the second stage in the application appeals process, which had a wait time of about seven months in 2023. But Waller said she is optimistic about O’Malley’s overall approach.

“He has only been commissioner since December, and [he has] already made some pretty big steps toward modernizing communications and access for representatives to claims and files, and really important [steps] that help speed up the process,” she said.

Further hurdles

The standard of medical proof required to obtain benefits presents another challenge for applicants, since some can struggle to find or afford adequate medical treatment.

“I find that many people come to me and they’re like, ‘My doctor won’t accept my insurance,’” Patel said.

While the SSA has a law that says the agency is supposed to take financial challenges into account when considering medical evidence, this has not always been Sappenfield’s experience.

“Often, there’s a lot of scrutiny on there not being medical records,” she said.

Patel and Sappenfield have also found that gun violence survivors often try to return to work after being shot. This means that some apply years after their injury.

“People will contact me with a gunshot wound that they had sustained many years ago, and then they worked, they didn’t. And they’re still in a lot of pain, but they haven’t really brought this up to doctors…That hurts [their application] as well, because anyone’s medical records—that’s the main evidence that Social Security will be considering,” Patel said.

In addition, returning to work itself draws scrutiny from the SSA.

“If you have someone that returns to work, maybe for a number of years, and then physically isn’t able to continue, or maybe mentally, it’s a lot harder to connect the two things, because from Social Security’s perspective, they think, ‘Well, you’ve returned to work. What is worse now than it was when you initially returned?’” Sappenfield said.

Finally, both Patel and Sappenfield said a majority of the survivors they represented were under the age of 35. This lines up with national trends: Three out of five victims of nonfatal shootings are under 30. But younger applicants are less likely to be approved. Social Security says they use age as a factor in their disability assessment because they assume that younger people will face less difficulty learning new skills and adjusting to new types of work.

“The younger you are, the higher the scrutiny is [about whether] you’ll be unable to return to the workforce,” Sappenfield said.

In the end, those who are denied benefits face a difficult choice.

“Either they’ll try to return to work and push through it, or they might just not be able to work. Unfortunately, they’ll kind of dig themselves into a deeper financial hole, where they have to take out loans from family members or friends, or some other means, or often move in with relatives. Often it leads to homelessness as well,” Patel said.

A threadbare safety net

The two main benefits awarded to successful Social Security disability applicants are monthly cash payments and enrollment in government health insurance. In most states, SSI applicants automatically qualify for Medicaid, while SSDI recipients must wait two years before becoming eligible for Medicare. While the gun violence survivors interviewed noted the importance of health care coverage, many said the cash benefits provided were too low.

The U.S. provides among the lowest disability benefits among OECD countries: The average monthly payment for an individual on SSDI is $1,537, just above the poverty line for a single person (the actual amount each person gets is determined by their work history). An analysis by Atticus found that this average benefit fails to cover the cost of living in any state.

SSI benefits, which are determined by a person’s income and household status, are even lower. The average payment for an individual is $697, below the federal poverty level. Most states, including New York, also provide an additional supplement to SSI recipients, which averaged just $202.76 per month in 2023.

“Often, when you’re applying for Social Security disability, you look at it as a beacon of hope. And then when you get approved, a lot of people do see it as, ‘Well, now I’m approved, but I still have a mortgage, or a car payment, or something. This is not going to be enough.’ And unfortunately, Social Security is not like an income replacement. It’s more like a safety net,” Patel said.

Ralph Norman was 17 years old when he was shot in the neck while hanging out in a car with his friends in his hometown of Yonkers, New York. Paralyzed from the neck down, he spent five years in a nursing home before returning to the apartment he grew up in. About three years ago, he joined the Rochester Spinal Association, where he now helps lead a national support group for gun violence survivors with spinal cord injuries.

Norman qualified for SSDI through his mother’s Social Security earnings, in what is known as Disabled Adult Child benefits, but he has struggled with the low payments. He currently receives $976 a month, which he supplements with food stamps and his income from working at Rochester Spinal Association.

“That little check is like nothing. You pay your rent, you buy food, you pay cable and cellphone, that check is gone,” he said.

Recipients of SSI can also have their benefits reduced if they are living with someone or getting assistance for some of their expenses.

“If someone is helping you pay for your rent, or your utilities, or your food, then Social Security will deduct that amount from your monthly payment because they’re saying your needs are being provided for,” Sappenfield said.

The agency recently adopted rules to remove food assistance and some forms of rental assistance as a factor in payment determination. They also expanded the definition of a public assistance household, a change they say will allow more people to qualify for SSI and increase some SSI recipients’ payment amounts.

These changes will become effective in September, but the maximum amount an individual on SSI can receive remains modest: $943 per month.

After adjusting to their disability, Norman said, some survivors seek to find work to earn more money, but income limits for Social Security beneficiaries discourages them from doing so.

Those on SSDI cannot make more than $1,550 per month, while those on SSI see their benefits reduced once they begin earning more than $65 per month. While SSA stressed that it varies based on individual circumstances, lawyers say that the effective income limit for an individual to remain on SSI is around $943 per month.

“It’s a risk because if it doesn’t work out, like if the job is not a good match, or if you get sick, and in the meantime you’ve been kicked off the benefits, now you have nothing,” Hilderbrant said.

SSI recipients also face a $2,000 asset limit, an amount that hasn’t increased since 1989 (it would be $10,000 with inflation today). This policy often discourages people from saving, keeping many recipients trapped in poverty. Recognizing this issue, a group of lawmakers in Congress has proposed legislation that would raise the asset limit to $10,000 for an individual and $20,000 for a married couple, but the bill is currently stalled.

SSA does operate work incentive programs, like a nine-month trial work period, which allows SSDI recipients to work and earn above the income limit for nine months before their benefits become reduced. People on SSI and SSDI can also participate in the Ticket to Work program, which provides vocational training and employment services as they seek to return to work. Recipients can also apply for expedited reinstatement if they become unable to work within five years of coming off benefits, although Sappenfield has represented people whose applications for expedited reinstatement have been denied.

Yin, the professor who studies disability policy, said the effectiveness of work incentive programs has been limited because people on disability have struggled to find and maintain employment after being out of the workforce for a long time.

“The longer you [are] out of the labor force, the more challenging it is to go back in, especially [for] young people—you need that attachment, you need that skill [and] experience,” she said.

That’s something Norman is grappling with.

“[Being injured at] 17 years old, I had a summer job, I worked a little, had a little experience, but it’s not enough. [If I say], ‘Oh, I want to work again,’ and it’s, five, 10 years later, [employers] are like, ‘Where’s your work history?’ A lot of places don’t want to hire you,” he said.

Partial disability: A better way?

Yin argues that there’s a more efficient way to allow people with disabilities to return to work: providing partial disability benefits. In countries like Sweden which have already implemented a partial disability program, people can apply for benefits at different levels with varying levels of disability, assessed as 25%, 50 percent, 75%, or 100% disabled. Those on partial disability benefits can work while applying for benefits and while receiving them.

There is also a system in the United States that uses this approach: The U.S. Department of Veteran Affairs’ disability benefits system assesses disability in increments of 10%.

Yin said an approach like Sweden’s recognizes that disability is a continuum, rather than a binary status. The partial disability system offers advantages for the government as well as individuals.

“The government should still win, because people can work and contribute to the system by paying taxes. And for individuals, if that’s what they want, [they] can live with dignity. Because people want to work, however, they [still] need some subsidy from the government. They can get a partial disability check, plus their earnings,” she explained.

Yin also said such an approach can reduce some of the social stigma that people on disability benefits face.

“All the systems have pros and cons, but in terms of how to retain people’s ability, not only focusing on their disability, I think [this is] something more forward-looking, more respectful for people’s willingness to work, and keeping people’s attachment to the labor force, and their dignity in making a living,” she said.

Kareem Nelson, a disabled survivor of gun violence featured in the first article of this series, recently came off of SSI because he began earning over the income limit. He agreed that a change is needed to provide better support for people with disabilities who want to return to the workforce.

When asked what one policy could be implement to help survivors of gun violence with disabilities, he said: “Allow us to work, and allow us to keep our [disability benefits].”

Shannon Chaffers is a Report for America corps member who writes about gun violence for the Amsterdam News. Your donation to match our RFA grant helps keep her writing stories like this one; please consider making a tax-deductible gift of any amount today by visiting https://bit.ly/amnews1.

This story originally appeared in the NY Amsterdam News.

Delayed & denied: How Social Security leaves gun violence survivors behind