Omaha attorney Timothy J. Cuddigan represents clients with physical and mental disabilities so severe that they can no longer hold a job. The first thing those clients want him to know when they walk into his office, he said, is how deeply they want to work.

By the time they come to Cuddigan, their only recourse is to seek Social Security disability payments—a process that can be so time-consuming and difficult that its consequences can be horrifying.

“In 2006, I had three people commit suicide,” says Cuddigan. “One lady drove her car into a train.”

In writing about financial planning for retirement, I’ve listened to many discussions of difficulties in qualifying for Social Security disability benefits. It comes up often in discussions of working longer in order to afford retirement. Inevitably, the talk shifts to those who can’t work longer because they’re disabled. There’s no finger-pointing—just general agreement that the system needs to be fixed.

At a hearing last year on Capitol Hill, Marty Ford, co-chair of the Consortium for Citizens With Disabilities Social Security Task Force, ticked off appalling stories of lives destroyed or made difficult to bear by delays in securing benefits—more than 60 stories of hardship, or worse.

One was the story of a Florida woman, whose husband shot her five times and who then killed himself. The woman survived, but in addition to her wounds, she had chronic obstructive pulmonary disease. After her claim was denied, she requested a hearing. In the meantime, her symptoms worsened and she died, nearly two years after she first sought benefits. Written notification that her benefits had been granted arrived after her death.

In another case, an auto accident left a 30-year-old South Carolina computer professional with such severe and chronic pain that he could not sit, stand or lie down for more than 15 minutes at a time without medication. He applied for benefits in January 2003 and was turned down twice, forcing his retired mother back to work to cover his medical costs. He was still pursuing his claim in 2006 when he died from an accidental overdose of pain medication.

Not everyone dies waiting for a hearing (or in the lobby awaiting a hearing, as one man did). Some cases are clear and relatively easy to resolve, says Virginia P. Reno of the National Association of Social Insurance (NASI). But others require a closer assessment to determine whether a person can work, given his or her disability, level of skills, level of education and previous work experience. And that’s where things bog down.

According to Ethel Zelenske of the National Organization of Social Security Claimants’ Representatives, more than 768,000 cases are waiting for a hearing as of December 2008—the highest number ever and at a time when staffing levels are the lowest since the 1970s, she says.

The number of claims processed is about 2.6 million a year now, and the average wait for a hearing is 480 days. Social Security Commissioner Michael J. Astrue has adopted several initiatives to reduce the backlog, tackling the oldest cases first. The number of cases in which applicants have waited more than 900 days or older was reduced from 135,000 cases to less than 300 during 2008. The agency is now working to shrink the backlog of cases 900 days old or older.

An electronic “compassionate allowance” program was set up last fall to fast-track claims for any of 50 severe conditions, such as acute leukemia or inoperable cancer. Also, during 2008, the Social Security Administration added 190 administrative law judges to hear cases, bringing the total to about 1,175 nationwide. In addition there are "quick disability determination" processes in all 50 states.

Even so, things are likely to get worse as boomers move toward retirement and into the years when disabilities increase. And, with the economy in retreat, disabled workers are more likely to lose jobs and have trouble finding new employment. In the summer of 1991, after an increase in claimants during the recession of 1990-1991, the House Ways and Means Committee chairman asked NASI to explore a series of questions about the Social Security disability programs, including whether people with disabilities exaggerate impairments to get benefits. The answer was basically that the payments were so low that anyone who could work would do so. The average monthly payment is currently $1,064, according to Social Security.

Shelly Howard of Fremont, Neb., is 40 and was diagnosed with multiple sclerosis eight years ago. Howard says that she would love to be able to work. Before her diagnosis, she blamed her stumbling and constant fatigue on her job as a certified nursing assistant and the fact that she had three young children, including 4-year-old twins. Then she woke up one morning with blurry vision. A spinal tap and an MRI revealed she had MS.

After her doctor told her to cut back to part-time hours, she switched to answering phones at the hospital where she worked. But after five or six years, a combination of incontinence and numbing fatigue made even that too much. Howard applied for benefits three years ago and has been denied four times. Her husband is working three jobs, and the family has medical insurance.

But they have to stretch to make ends meet. Howard says that the family lives paycheck to paycheck; after paying bills, they're left with $80 to $100 each week for fueling two cars and feeding a family of five. They've re-mortgaged the house twice so they can live off of the equity and cashed in Howard's retirement account. Howard said she lives in fear her husband will lose his jobs, and they will lose everything.

Martha M. Hamilton was a reporter and editor at the Washington Post for 30 years. Her column, Your Financial Future, appears regularly on AARP Bulletin Today.