Many are unaware of this fact: after one is found eligible for Social Security disability payments, there is a wait of 25 months until Medicare coverage begins. Sometimes the wait is fatal.

Sue Sherman, the subject of a June 2010 story in The Oregonian about her quiet effort to raise awareness about the Medicare waiting period for Social Security disability recipients, died Tuesday of pancreatic cancer. She qualified quickly under compassionate allowances for Social Security Disability Income in 2009, then learned of the two-year wait to enroll in Medicare — a gap instituted in 1972 to keep costs down, avoid overlaps with private insurance and to preserve Medicare for those with severe, long-lasting disabilities.

At least 15,000 Oregonians are among the 1.8 million Americans who must wait two years after obtaining Social Security disability to become eligible for Medicare. The only exceptions to the Medicare wait are for people in end-state renal failure or with amyotrophic lateral sclerosis. SHe became eligible for Medicare in October 2012.

Through 2009 and 2010, Sherman contacted politicians and policymakers to point out that many disabled people spend their savings on the medical care necessary just to reach a diagnosis and can no longer get private health insurance.

For at least the past two sessions of Congress, a proposal has come forward to phase out the waiting period over 10 years. But the Congressional Budget Office calculated the measure would cost an average of $10 billion a year, and the proposal went nowhere. See article here:

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The Oregonian reports:

“Sue Sherman of Southwest Portland lived a peaceful, healthy life until she was dealt an ugly card last year: a diagnosis of pancreatic cancer.

“From the whirl of appointments, tests and drugs arose an enduring irony of any serious illness: too many moments surrendered just to the act of waiting, for doctors, for results, for help.

“Sherman, 57, believed she had bought some time when she qualified for Social Security disability income. But that only brought on the worst wait of all.

“How do people survive this?” she said. “The ripple effect of this is tsunami-huge.”

“She joined nearly 2 million disabled Americans — at least 15,000 in Oregon — who fall into a twilight with the first monthly Social Security disability payment, for they then must wait two years to become eligible for Medicare.”
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Over the past year, the newspaper The Oregonian, Portland and Oregon’s local paper, has been running a series carefully documenting the devastating delays at the Social Security hearing offices, putting a human face on this non-comedy of errors and underfunding. Brent Walth and Bryan Denson of The Oregonian have just won the prestigious Bruce Baer Award for Investigative Reporting, for uncovering the enormous backlog of disability claims in the Social Security system. The articles showed that while claims management is a nationwide problem, Social Security Administration’s Portland office has one of the slowest case-completion rates in the country. The reporters found several cases in which claimants died while waiting for a benefits determination from the office: On average, it takes nearly two years for the Portland office to handle the appeal of a case.

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Today’s Portland Oregonian reports that despite an infusion of $148 million and attention at the highest levels, the Social Security Administration has made little progress reducing an enormous backlog of disability claims for the nation’s sickest and most vulnerable people, a House subcommittee heard Tuesday.

The hearing into the agency’s record came amid rising criticism for the bulky and overloaded system that often forces aged, blind and disabled Americans to wait three years or more to learn if they qualify for disability payments that average $492 a month. See Oregonian story here:

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