Social Security offices have been closed for most of the pandemic. That effort to protect public health has wounded some of the neediest Americans.

Two hours west in Jackson, an old cotton city where almost 1 in 4 people live in poverty, Beth Bates, a legal services attorney, reviewed 4,000 pages of medical records she needed to know cold for an upcoming appeal for a client with degenerative disc disease, breathing problems and borderline intellectual function who had twice been turned down for benefits. The third effort had stalled because the state could not find a psychiatrist to conduct the required exam, she said.

More than 31,000 similar medical reviews of applications and initial appeals were awaiting a decision in August, the most recent month for which data is available, from Tennessee Disability Determination Services. That represented a 28 percent jump from before the pandemic, according to an analysis of federal data by Stacy Cloyd of the National Organization of Social Security Claimants’ Representatives. State officials blamed the setbacks on slow mail delivery, power and Internet challenges after a tornado in March 2020, a bombing in Nashville in December 2020, and a new case processing system causing delays nationwide.

A judge in Memphis offered Bates and her client a phone hearing, held this month. Bates worried that the judge would miss important information about her client’s condition without seeing her in person. They’re awaiting a written decision.

In October, Bates, now 62, celebrated 34 years representing the disabled for West Tennessee Legal Services, headquartered in a dated one-story building on Jackson’s dying main street and serving 17 rural counties.

Even with all of her knowledge of arcane disability law, the pandemic still confounds her: There’s the client with multiple health problems who won an appeal of Social Security’s claim that he was overpaid, but whose $1,281 monthly check continued to be garnished $75 for more than a year because of a mistake by the payment center in Birmingham, Ala. The error was finally corrected, but the man has yet to receive a refund for the money he lost.

“It’s pending,” Bates said dryly.