I’m a lawyer, but I was barely able to navigate the food assistance bureaucracy in Massachusetts. Even in one of the most liberal states in this country, the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) is already so hostile to hungry people that had I not had a legal education to help me steer through, I would have starved.
Now, Congressional Republicans are trying to make it even harder for the frailest, poorest, and most vulnerable Americans to access food assistance. They seek to impose harsh new work requirements that will force some of the most marginalized Americans to run a convoluted labyrinth of wage and hour verification paperwork over and over again.
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It is a transparently cynical move to chop the program and take food from people who are hungry. Even those who do everything the system demands will be denied assistance—and I am absolutely certain of this, because it almost happened to me.
A few years ago, I was sick and getting sicker. I was not yet sick enough for surgery but far too sick to work.
I have Crohn’s, a chronic, incurable inflammatory bowel disease that causes my immune system to shred portions of my own small intestine. On a certain level, it’s a simple plumbing problem: the small intestine is like a long flexible pipe that brings food from the stomach to the large intestine, winding and twisting back and forth in the abdomen. When scar tissue builds up, it constricts the pipe, making it too narrow for most foods to get through. And then the pipe can clog.
Those clogs are called “small bowel obstructions” and, unlike a backed-up sink, they’re a potentially life-threatening medical emergency. I’ve experienced the special hell of having a tube shoved up my nose, down my throat, through my stomach and into my small intestine. I’ve watched as that tube sucked small bits of almond out through my nose. And, with some of the finest professors of surgery Harvard Medical School has to offer, I’ve discussed the odds that I’d live through emergency surgery if suction didn’t work.
After the almond incident, my physicians prescribed a strict low-residue and low-FODMAP diet. I was highly motivated to adhere to it; I understood the stakes. But as I got sicker and became unable to work, I could barely afford any food, never mind the diet my physicians prescribed. I didn’t have any income. So I applied for SNAP.
First, I faced an extensive application. But, more importantly, I was told that a face-to-face interview was required, and that the Massachusetts Department of Transitional Assistance (DTA), the state agency charged with administering SNAP, scheduled the interview on their timetable. As an applicant, you showed up when they told you, where they told you—or no food for you.
My life at this point consisted of debilitating symptoms: constant diarrhea, severe abdominal pain, nausea that even powerful prescription anti-emetics barely controlled, anemia, arthritis, and crippling fatigue. But despite my failing health, I had not been declared disabled by any government agency.
Under the current SNAP eligibility rules, an “Able-Bodied Adult Without Dependents” (ABAWD) between the ages of 18 and 49 can only receive 3 months of SNAP benefits in any 3-year period if they do not meet the existing SNAP work requirements. Yes, there are already work requirements for SNAP, but Congressional Republicans are pushing for still more draconian rules. They assure us that just as disabled folks are supposed to be exempt under the current rules—an exemption that has proven elusive—they will be exempt under the new regulations, too.
However, proving disability to the government is exceedingly difficult. First, it virtually requires ongoing, meaningful, affordable access to comprehensive medical care. Without medical records, government agencies are loathe to find an applicant disabled. (Yet, conservatives are also working to roll back access to health care at every turn, including by imposing work requirements on Medicaid, making care even more of a challenge to obtain.) Proving disability also often requires the cooperation of overworked health care providers in completing legal forms they’re not trained to deal with. Doctors are taught to diagnose and treat, not judge someone’s capacity to work against specific, highly technical legal criteria. And it means a lot of work for the applicant—work they may be too sick to do.
When I was eventually healthy enough to apply for Supplemental Security Income (SSI), it took dozens of hours of work from me to gather, review, and collate my voluminous medical records (over 500 pages). It took even more time to complete the application forms Social Security sent me. I approached the work and writing that formed the basis of my SSI application like it was an appellate case before the Massachusetts Supreme Court. In total, just applying for SSI took me more than two months of working whenever I was medically able. I was fortunate enough to get approved for SSI at the initial application stage. Many people my age don’t.
Because I was so sick, I asked DTA to conduct the interview for my SNAP application via telephone. I also asked that the call be in the afternoon because my symptoms were a bit more manageable then. As an attorney, I had the benefit of knowing that the Code of Massachusetts Regulations, part of the law that governs SNAP applications, required that DTA grant my request. But DTA didn’t reply—or at least, I thought they didn’t reply.
Despite giving DTA my full, complete, and correct address, that’s not where they were sending letters. They failed to include my apartment number on the mail they sent me. (As if I lived in a house, when I couldn’t even make the rent on my half of a tiny one-bedroom apartment.) DTA screwed up, I never got their mail, and I wasn’t receiving SNAP.
I called my DTA caseworker, just as I was supposed to do. I would call and then wait on hold for 30 to 45 minutes. An operator would then answer, and transfer me to a voice mailbox. (I wasn’t given the option of directly dialing the extension.) If the voice mailbox wasn’t full, I would leave a message. If it was full, which was usually the case, I would have to start over. After another 30 to 45 minutes on hold, I’d ask the operator for a different case worker, and leave that person a message. I repeated this process daily.
While waiting for DTA to return my many messages, I could never, ever allow the phone to go unanswered—they simply wouldn’t try calling again. No matter how sick I was, no matter if I was vomiting or toileting or running a 103° fever, if I missed a phone call from DTA, during my next interaction with them, they’d accuse me of “non-compliance.”*
Usually the person returning my desperate messages was someone who didn’t “know the file” and whose only reply to my desperate questions like “What do I need to do in order to schedule the formal interview?” was “Sorry, can’t help.” I was slipping through the cracks.
Because I am a lawyer, I knew that if I could somehow hang on long enough, I could eventually get my case before an administrative law judge. And, because I am a lawyer, I knew how to keep a log of every single SNAP related phone call I had in a way that a judge would understand and likely find credible. I knew which conversations I was legally allowed to record, and which I wasn’t. I knew what was important to include in the notes I took during every call. Or I did sometimes. Other times the pain, the fatigue, and the brain fog from the methotrexate—a chemo drug used to treat autoimmune diseases—was too much and I couldn’t think straight. I could only hope they didn’t call then.
And then one day, after weeks of waiting and dozens of hours spent trying to fight my way through the red tape, I finally got a piece of mail from DTA. I opened the letter outside. It was summer, and I wasn’t supposed to be in the sun because of one of the medications I was on. They denied my application because I didn’t attend the “in-person interview.” I sat in the street and cried—and I wasn’t supposed to cry, either. After choking down homemade oral rehydration solution, I got to work on this:
What you’ve just read is, essentially, a legal complaint and a motion for a hearing before an administrative law judge. Although the letter is just two pages, dozens of hours of research went into drafting it. Not to mention four years of college, two years of public health graduate school, and three years of law school that enabled me to research the pertinent state and federal statutes and regulations, as well as find and analyze all the relevant legal rulings. In response, DTA reversed the denial and awarded benefits retroactive to the date of my SNAP application. The entire process had taken 10 weeks.
My question for Congressional Republicans is this: Could you—while in constant pain, malnourished, dehydrated, and terrified of eating the wrong thing because it could kill you—have done better? Adding more punishing work requirements for nutritional assistance will harm some of your most vulnerable constituents.
In the wealthiest country in the world, you shouldn’t need to be a lawyer to get a little help with food.
* Editor’s note: A DTA spokesperson says that subsequent to the author’s applying for benefits, the agency has made numerous “reforms,” including: a “simplified SNAP application,” a mobile app for smart phones, a web-based portal for clients “to self-service and view their information,” and allowing any available caseworker to assist an applicant.