Linda Fullerton's health problems began after she bumped the back of her head while getting out of her Chevy. It seemed, she says, like the kind of harmless clunk everyone takes from time to time. But within hours, the bump had swollen to the size of a tennis ball, and Fullerton was in pain. After several visits to the doctor, she says she was told that her bruise had caused a blood clot to form between her scalp and her skull, and that it was nothing to worry about. The doctor told her, she says, to go home, take aspirin, and rest until the swelling went down. Fullerton, in her mid-40's at the time, eventually slipped into a coma. She had part of her skull removed in an emergency operation to save her life.

But Fullerton's real-life horror story had barely begun.

Her health continued its downward spiral. After massive doses of antibiotics to control her infections, Fullerton, a computer purchasing agent, says she began developing a series of autoimmune diseases that made it impossible for her to work, so she applied for Social Security Disability Insurance (SSDI). But like millions of American workers who become disabled annually from accidents or disease, Fullerton soon discovered the government program that had taken deductions from her paycheck for more than 20 years, was in no hurry to help. That began a journey, she says, she wouldn't wish on anyone.

More than two-million Americans apply to the federal government for SSDI benefits each year and more than 70 percent are denied. Applicants can appeal the denial, but as many as 85 percent of those first appeals are also denied. While thousands of people give up, there are those who continue appealing until they get a hearing with a Social Security Administration judge. There are currently 750,000 people waiting for their first hearing. Caught in a waiting game that is averaging two years to get a hearing that may not even lead to an approval for benefits, thousands of applicants spend their savings and pensions trying to stay afloat. Many file for bankruptcy and lose their homes in foreclosure. Cars are repossessed, while marriages dissolve and families fall apart. Many people have to manage their application process while their illnesses progress, until they become too sick to continue.

"It is simply outrageous that so many individuals who need Social Security Disability Insurance to survive are forced to wait years before they receive the benefits they deserve," says Congresswoman Louise Slaughter.

For many, the help doesn't come soon enough. Social Security Administration Commissioner Michael Astrue, in a September 2007 report, said that US citizens are dying while waiting through an "uphill battle simply to get a hearing." The SSA estimates that 16,000 Americans have died while waiting for approval since the year 2000. Critics say that estimate is low.

Disabilities that prevent people from returning to their current jobs or other jobs in their field, do not meet the standard for approval. Applicants have to prove that physical or psychological conditions prevent them from returning to some type of work. Maybe the individual can't continue working as a landscaper, for example, but they can stand at a cash register at a grocery store - which would be reason enough to deny the application.

But an accident or disease that keeps people out of work for 12 months or longer frequently sets a financial catastrophe into motion - even for people with health insurance and money in the bank. Most people don't have enough of a financial cushion to cover six months of unemployment. Add illness or a debilitating car accident, and the situation can be devastating.

Fullerton, who suffers from several chronic pain conditions, was recently diagnosed with a brain tumor. She applied for SSDI benefits in December 2001. She was denied three months later. A year-and-a-half later, she was approved - after she had cashed-out her pension.

"Most people don't have a clue of what they're facing when their doctor looks at them and tells them, ‘You better apply for Social Security Disability,'" she says. "They told me it would be three to six months before I even heard from them. I said, ‘How am I supposed to live?' They told me to apply for public assistance, so I could receive food stamps. But I was denied there, too, because I had a life-insurance policy. That was all I had left, except my clothes. It wasn't even enough to bury me."

Where you live can determine how quickly your disability application is reviewed. SSDI applications are initially processed in the regional SSA office in an applicant's home state. Applications in Upstate New York, for example, are usually reviewed in the Buffalo office, which has one of the largest backlogs and longest waiting times in the country. Out of 144 cities in the country, Buffalo ranked 138 with a processing time of 702 days per applicant as of December 2007, according to the SSA.

The backlogs in the SSA offices are largely attributed, officials say, to a series of SSA funding cuts, which began in the Clinton administration and continued under President Bush. Most of the offices are understaffed, which has complicated the process for applicants. While applicants submit their information to the regional SSA office, the medical review is made by the state or federal agency through which the regional SSA has subcontracted the work. That agency may not even be in the same state. It varies with each state, which makes it difficult for applicants to get a clear sense of who is handling their claim and the status of that claim. The SSA hires adjudicators who are not medical professionals to review the applicant's file.

"People who you probably will never see are evaluating you," says Fullerton. "They're reviewing medical records and case files that are four to five inches thick. They can't possibly go through them all. And they don't realize that a stroke of a pen can destroy a life."

If an applicant is denied by one adjudicator and the applicant appeals, chances are an entirely new person will get the case.

"What really bothers me most is that we are not asking for a handout," says Fullerton. "They're not giving us anything. When you look at your paycheck and you see the deduction under FICA being made to Social Security every two weeks, this is why the federal government takes that money from you. You don't have a choice. All I am saying is, give us back the money you took. It shouldn't be like this. We shouldn't have to beg for it."

John Johnson is a disabled Army veteran. Even though a panel of medical examiners with the Veterans Administration reviewed his injuries and, he says, determined he was 100-percent disabled. Johnson's application was denied by the SSA.

"How can one federal agency tell you one thing, and another tell you something completely different?" says Johnson. "It doesn't make any sense. It's crazy. I was injured serving my country. I was doing what I was supposed to do. I don't know if they are doing what they're supposed to be doing, but that's the kind of bureaucracy that you're dealing with."

Johnson's first SSDI denial came in February 2004. He appealed and was eventually approved in July 2007, but, he says, the financial pressures broke-up his marriage and he almost lost his home in foreclosure. He has chronic pain in his lower back and legs and cannot sit or stand for any length of time.

"The depression that comes with this is so great, you just don't know if you will get through it," he says. "I would try to call to find out what was happening, why it was taking so long, and if they needed something else from me. And I would hold on the telephone sometimes for 30 minutes or longer, only to be told that I had the wrong person, that they didn't have the case anymore, or something like that."

The physical conditions that lead to disability are not always visible, Johnson says, causing others to misunderstand what a person is experiencing. And often, psychological issues accompany the physical. Johnson says he experienced mood swings from severe depression to rage, as he tried to cope with the changes in his life.

"People see you and they are not seeing someone who fits their understanding of being disabled," he says. "You're not blind or moving with jerking motions, so they think you want disability because you're just lazy. You don't want to work. And nothing is farther from the truth. You long to return to your old life."

Johnson was able to keep his home, but Terry Nichols was not so fortunate.

"At first they thought I had a stroke," says Nichols, who owned a landscaping and lawn-maintenance business until 2001. "I had some speech problems and what seemed like paralysis in part of my body."

A year later, Nichols developed vision problems.

"I went blind in one eye for a while, and I started having cognitive problems," he says. "Then I was having problems with my gate and keeping my balance. That's when I was diagnosed with MS."

Nichols's first application for SSDI was denied. While he waited to hear the results of his appeal, Nichols went through his life savings. He sold all his lawn-care equipment, but he couldn't keep his home from being foreclosed.

"I think the system is set up to try and discourage you," he says. "They would rather that you just go away. They shouldn't be allowed to drag their feet so that a person loses everything like this. I got to the point where I didn't even have the money to file for bankruptcy."

While the average wait for a hearing in Upstate New York is two years, some applications linger in the system even longer, bouncing from office to office, and adjudicator to adjudicator. Tamara Milds-Stallworth has been trying to get approved for seven years.

Milds-Stallworth was a nurse's aid when she was injured lifting a patient. Her problems worsened when her mother was murdered.

The trauma has left Milds-Stallworth with panic attacks, among other problems, and, she says, she rarely leaves her home. She says she received a letter in the fall saying she was approved, but now a new judge has ordered another hearing.

"It's like my life is hanging from a string," she says.

Rochester attorney Steve Modica has worked with people on their SSDI claims since 1993. The process is lengthy, he says, because millions of aging Baby Boomers are experiencing health issues that prevent them from working.

"The people in the SSDI offices are hard-working people just doing their jobs to the best of their abilities," he says. "They are not awful people trying to make the problem worse."

The economy, especially in Upstate New York, has been bad enough to cause people to seek alternate sources of income following a layoff, says Modica. The government, he says, has to screen for those who are trying to commit fraud.

"We've all seen the 60 Minutes or 20/20 story that shows the guy who is supposed to be disabled because of back pain, and the investigator catches him on camera playing basketball or unloading something heavy from the back of his truck," Modica says. "Unfortunately, those images give the general public the impression that most people are lazy cheats, and I don't think that's true. Those cases are the minority. I find that the vast majority of people underestimate their problems. Most people I meet would rather be doing anything than sitting down here to talk to me. But they have to screen for people trying to game the system, because that takes money away from those people who really need it."

Screening for fraud may contribute to the delays, but there is little evidence that SSDI is an abused system. The average SSDI payment is only $975 a month. Recipients still pay taxes, and those who don't qualify for Medicare of Medicaid have to pay for health insurance, as well as their other living expenses.

"Think about it," says Fullerton. "Why would anyone in their right mind go through all of this for so little money? Great, you've beaten the system and just committed yourself to a life of poverty. Who does that?"

Rick Warsinskey is the past president of the National Council of Social Security Managers, which represents 3,500 SSA managers in the field offices. He is currently the manager of the SSA office in Cleveland, and he has testified before Congress four times. There are several reasons for the backlogs, he says.

"I don't think we really know how many people abuse the system," he says. "I don't think it is a terribly big problem, but there are offices that investigate fraud, which takes time and manpower."

But Warsinskey says that 50 percent of all cases that are approved are reviewed because it is required by law, which slows the process down considerably.

"I can tell you that the biggest problem by far is staffing," he says. "There are not enough judges to handle the hearings. There are 150 new judges coming in 2009, but it will take time to see the improvement. And the field offices are really squeezed."

There may be reason for cautious optimism. Congress recently approved $9.7 billion, most of it for SSA's general operations. But some of the funding is intended to reduce backlog.

But the problems with the SSA's handling of disability applications goes far beyond staffing shortages and years of cost-cutting, says Trisha Cardillo. As an adjudicator and trainer in an Ohio office, she worked inside the system for years, reviewing between 100 and 250 cases a month. She says the system operates on a "culture of denial."

"There is pressure to keep cases moving," says Cardillo. "I wouldn't say there is a quota system, but there is intense pressure to keep anything from being approved. And when you are trying to move as many as 200 cases forward in a month, you're going to start denying. I've had people in so much pain that they were on enough morphine to knock out a horse - denied."

Cardillo describes a system with widespread turnover, adjudicators that ignore court rulings on medical conditions, and in-house clinicians making decisions on claims from applicants they may never meet or evaluate in person. The problems, she says, have been evident to Congress for years, but there hasn't been incentive to change.

"I talked to people every day who were crying because their cancer was getting worse, they had lost everything, they were living in their car, or they were moving from one relative's sofa to the next," she says. "But I knew approving them would mean such a fight with my superiors, that it got ridiculous. Even the most cold-hearted person would be mortified to know what some of these people are going through."

It all comes down to money, says Cardillo.

"You're warned that every approval means millions to the government," she says. "And they know that a certain percent of people who are denied the first time are not going to appeal. They stop there. And they know that another percent of people will appeal, but they'll just give up instead of waiting. They bank on it."

Both Cardillo and Fullerton say that the SSDI system has benefited from a shield of secrecy, and the women try to use their experiences to help others navigate the system. Cardillo, who operates a SSDI advocacy service in Atlanta, likes to use a phrase with new applicants: You don't know what you don't know.

"If you don't know what questions to ask, they sure aren't going to tell you," she says. "And what you don't know will cause your case to take longer to get approved."

Fullerton, who lives in Greece, co-founded the web-based Social Security Disability Coalition. People from all over the country visit the website to exchange information, and to offer emotional support and coaching. Fullerton exercised her legal right to see all of her SSDI records. She says she discovered that her file was, full of misinformation.

"Things like getting copies of your records are things I had to learn on my own," says Fullerton. "The website is the least I could do. If I can help someone avoid the nightmares that I went through, I'm fine with that. There was a time when I didn't know if I would live this long. Now I think it's the reason I'm still here."