WEBSTER COUNTY, Miss. On the 597th day, the day he hoped everything would change, Joe Stewart woke early. He took 15 pills in a single swallow. He shaved his head. And then he got down to the business of the day, which was the business of every day, and that was waiting. He looked outside and saw his mother there in a green sedan, engine running. So many months he had waited for this moment, and now it was here. Time for his Social Security disability hearing. Time to go.

Stewart, 55, set out on crutches, tottering out of his mobile home and down a metal ramp he’d laid when stairs became too much. “I’m sweating my ass off,” he said, getting into his mother’s car, his long-sleeved dress shirt hanging open. He tilted the passenger seat all the way down, placed a pillow at the small of his back and settled in as best he could, groaning and wincing.

“Did they say long-sleeved?” asked his mother, Jean Bingham, 73.

“It was the only decent shirt I had!” he said.

He knew only what he’d been told by his lawyer, who wanted to see him again before the hearing, and that was not to wear a T-shirt and to bring along a list of medications he uses to treat the pains that are all he has to show for a lifetime spent installing vinyl siding throughout Webster County. Neurontin for nerve pain. Baclofen for muscle spasms. Trazodone for depression. Hydroxyzine and Buspirone for anxiety, a condition that seemed to worsen each day his wait stretched into the next.

Stewart had first applied for federal disability benefits on May 21, 2015. The application was denied, and so was his appeal. When he appealed the second rejection, he went to the back of one of the federal government’s biggest backlogs, where 1.1 million disability claimants wait for one of some 1,600 Social Security administrative law judges to decide whether they deserve a monthly payment and Medicare or Medicaid. “A death sentence” is how Stewart, who has no health insurance, has come to think of another denial.

For other applicants, the wait itself may be enough to accomplish that. In the past two years, 18,701 people have died while waiting for a judge’s decision, increasing 15 percent from 8,699 deaths in fiscal 2016 to 10,002 deaths in fiscal 2017, according to preliminary federal data obtained by The Washington Post. The rising death toll coincides with a surge in the length of time people must wait for a disposition, which swelled from a national average of 353 days in 2012 to a record high of 596 this past summer.

The simplest explanation is that there isn’t enough money. The Social Security Administration’s budget has been roughly stagnant since 2010, while the number of people receiving retirement and disability benefits has risen by more than 7 million, despite a slight decline in the disability rolls beginning in 2015 as some beneficiaries reached retirement age.

The more complicated explanation, however, also includes fewer supporting staff members helping judges. A recession that increased the number of applications and appeals. A new regulation that requires additional medical evidence, lengthening the files judges have to read. And heightened scrutiny in the aftermath of a 2011 scandal in Huntington, W.Va., where one judge, who approved nearly everyone who came before him, was later convicted of taking $600,000 in bribes. Since then, according to a September report by the Social Security Administration Office of the Inspector General, the average judge has gone from deciding 12 cases every week to fewer than 10, a relatively small slowdown that, spread across hundreds of weeks and hundreds of judges, has contributed to the crushing backlog.

“I know that people will die waiting,” said Marilyn Zahm, president of the Association of Administrative Law Judges. “This is the reflection of our priorities as an American people. We have decided it’s better for people to die than to adequately fund this program. . . . Will this get worse? Will the number of people who die double?”

While lengthy everywhere, the wait times have stretched longer still in some places, such as in Miami, where people wait an average of 759 days, and Long Island, where the wait is 720 days, and northern Mississippi, where the average is 612 days, and where Stewart couldn’t stop shaking in his car seat.

“My shirt is undone, I ain’t going to be able to put it in my pants. My pants are too tight,” he said, rummaging through a red bag filled with his medications, realizing he had forgotten to bring something to eat.

“You didn’t eat no breakfast?” his mother asked.

“I ain’t have the time!” he said.

He hadn’t felt pressure like this in years — not since he last worked in April 2015, and his world was reduced to food stamps, credit cards and the confines of a single-wide trailer, parked along a country road that few cars go down. He had thought about this day ever since. What would the judge ask him? Would he believe him? Or would he think he was lying, too lazy to work? Would he finally get an answer, or would the wait continue?

Stewart took an anxiety pill and looked at the car’s speedometer.

“Never going to get me there in time,” he told his mother as she steered through the remote county of hills and pine where nearly 1 in 5 working-age adults receive either Supplemental Security Income, for the disabled poor, or Social Security Disability Insurance, for disabled workers.

He fidgeted with the air conditioning vents, opening them up.

“I’m going from chills to hot spells,” he said. “I’ve got hot spells now.”

He leaned back.

“I’m getting cool.”

Then: “I’m sweating.”

Then: “I’m getting worse now.”

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For most of his life, Stewart had believed things could only get better. He had been raised with the conviction that a man was only as good as what he could accomplish with his hands, and so he had always felt good, because he could do so much with his. After high school, he started out building furniture. Then he worked as a carpenter. But vinyl siding was what he loved completely. Cutting the metal. Measuring it out. Hauling it in his truck and completing a job worth being proud of, worth attaching his name to, and that was a promise he made to every customer after opening his company, Premium Siding, 10 years ago.

At the time, the county was in the midst of a steady and precipitous decline, accelerated by a recession that never seemed to end, and Premium Siding’s profits were barely enough for Stewart to survive on, let alone pay for health insurance. So already carrying two decades of work injuries — falling off ladders, getting shocked by hot wires — he would sometimes go to a community clinic that charged $35 per visit. Or more likely, he’d use a heating pad and try to think about anything but pain, until one day in the summer of 2013, when pain became nearly the only thing he could ever think about.

He can’t remember what he tried to pick up. He remembers only that he had been out at a work site, lifting and cutting 50-pound coils of metal. He remembers reaching for something that had barely weighed anything. He remembers the sharp, immediate pain, the sudden realization that his back might never be the same, and that, for everything he would ultimately lose, he had never even touched whatever it was he had reached for.

Outside Gibson’s office, Stewart held a stack of medical papers and, disoriented, tried to listen as his mother asked question after question.

“Are you taking those in there?” she asked of the documents.

“How long is this going to take?” she asked.

“Are you going to be okay?” she asked.

“Remind me to tie my shoes,” was all he managed to say, going inside the law office, shoelaces flopping this way and that. He took a seat in a back room, head full of doubts. If he couldn’t focus well enough to answer his mother’s questions, how was he going to answer the judge’s?

“Joe,” Gibson said, riffling through all 169 pages of his medical file. “Let’s go over what you do all day.”

Stewart didn’t say anything. His mouth was dry. He was still wearing sunglasses he’d forgotten to take off.

“What time do you get up?” Gibson asked after a moment.

“Around nine,” Stewart said.

Gibson cringed.

“How many of your medications — make you lightheaded?” came another question.

“Quite a few,” Stewart said. “About half.”

Another bad look came over Gibson’s face. He tapped his pen against the folder.

“Make no mistake, if you don’t do this well, you’re going to lose,” he said slowly. “You’ve got to speak up and tell him what is what and not be vague. ‘Sometimes.’ ‘A little while.’ ‘A little bit.’ ‘Not very much.’ ‘A whole lot.’ All those words. They don’t mean anything. They don’t mean anything.You might as well just open your mouth and close it. Because nothing comes out worse than those vague words. And I just want to grab people and slap them — wake up! You can’t just say ‘sometimes’ with a judge!

“Lord, mercy,” Gibson said, telling Stewart that he could not have drawn a stricter judge. James Prothro had the 31st lowest approval rating among Social Security administrative law judges, according to a Washington Post analysis of every judge’s disposition record between January 2010 and April 2017. During that period, Prothro decided 2,610 cases, approving 27 percent of them.

Later, Stewart would get angry. He would think about all of the people he had seen in Webster County receiving benefits whose disabilities he considered milder than his, and wonder how they had gotten them, and why everything had to be so difficult for him. But at that moment he just nodded slowly, wanting to absorb everything Gibson said — stand to show he couldn’t sit for long; never say, “I don’t know” — until Gibson rose from his seat.

“You have a slim shot,” he said. “People sitting around the house, watching TV all day, they’re not used to talking, and I understand that. But I have to get you to talk. Tell the judge the things the judge needs to know. Can you do that, Joe?”

And then Stewart was back in the car, and he was rummaging for his anxiety medicine, and he was saying, “I need to put it in my pocket so I can remember to take it,” and he was going into a courtroom, and the door behind him was closing, and it was locking, and he was trying to stay calm.

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Five-hundred and ninety-seven days.

One-hundred and sixty-nine pages of medical evidence.

One hearing.

How to condense so many years of physical deterioration, so many days of waiting, into one hearing? How to convince someone of pain, when no one can see it? How to remember to say everything that needed saying — the pills taken, the number of pounds that can be lifted, the distance that can be walked, the falls, the different doctors and their names?

So Stewart did his best to follow Gibson’s directions. He carried his back pillow into the courtroom. He stood when he felt pain. He was specific. He said, “burning in the chest.” He said, “I went to see my chiropractor, but they wanted $60, so I haven’t been back.” He said, “My mother, she’s tired of driving me around; she has other things to do.”

And he tried to look at the judge, to express with his eyes what he couldn’t with words, but the judge wasn’t in the room at all. He was sitting in front of a camera in another courtroom 65 miles away in another Social Security Administration building in Tupelo, part of a government policy to work down the backlog by holding some disability hearings by videoconference.

Stewart heard the disembodied voice of someone whom Gibson called a “vocational expert,” whose role it was to use, among other sources, the government’s list of possible jobs, the Dictionary of Occupational Titles, last updated in 1991, to discern whether there was any work someone like him could do anywhere in the United States, regardless of pay, distance from his house, or whether he would be hired.

And then an hour had passed, and the hearing was over, and Gibson was saying, “Thank you, your honor.” Stewart, feeling dazed and unsure whether that was really it, sat for a moment, until he saw everyone else was standing. He got up. He collected his crutches and walked outside with Gibson, who was going on and on about the judge.

“One lawyer — a good lawyer — they had 13 cases with him, and they didn’t win a one,” he said. “Not a one.”

“Whether or not he’s going to pay you, I do not know,” he said.

“So we’ll wait and see. . . . You might not get a decision until February.” And: “It may be six months.”

Gibson said something about errands he had to run, shook Stewart’s hand and got into his bright red truck. And Stewart, now caught in another backlog of people awaiting a disposition after the hearing — which has doubled in the last year, from 35,000 claimants to 70,000 — watched him drive off, then saw his mother. She was in her car, waving at him to move it, so he climbed in and reclined the seat until he was nearly supine.

“Can I ask you a question?” said his mother, who had sat outside the courtroom but overheard something about a videoconference. “Was he in there?”

“Who?” Stewart asked.

“The judge.”

“No, he was on TV,” he said, and she looked confused.

“Well, I’m relieved it’s over,” she finally said.

“It ain’t over,” he responded, and there was nothing else to say, so on they went to Webster County, through the endless rows of tall pines, past the houses Stewart had once worked on, stopping at his trailer. “There’s another day,” his mother said and pulled away, and he was alone again. The trailer was dark inside. He took his afternoon medication. He sat in his Ab Lounge. The television came on. The pills started to do their work. The 597th day was over, and the only thing left to do was to wait for the 598th to begin.

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