Fraud Bad for the Disabled

The Rise of Disability Fraud: Bad for the Disabled

Most people who file for Social Security disability benefits can no longer work and SSD is the only option available to them. Unfortunately, for others, filing for disability is type of fraud because they are not really disabled. Moreover, their actions limit the funds available for truly disabled Americans and contribute to making the claims process longer and more arduous.

The number of Social Security disability claims has grown in recent years. According to the Social Security Administration (SSA), over 3 million claims have been filed so far in 2011, compared with 2.6 million claims filed in 2008. The rise in disability claims is due to many factors that include the poor economy, the aging population and the rise in ailments and injuries that are considered permanent or debilitating. However, several investigative reports have indicated that fraudulent claims may be another factor in the increase.

Stanley Thornton Jr. was profiled on National Geographic's television program "Taboo" for his distinct lifestyle. Thornton allegedly suffers from a medical condition called paraphilic infantilism, which causes him to act like a small child. Thornton wears diapers, sucks on pacifiers and plays in a playpen, supposedly as a mechanism to deal the trauma and abuse he suffered during childhood. Because of his condition and other ailments such as depression and post-traumatic stress disorder, Thornton receives disability benefits of $860 per month. Despite his disability, however, Thornton is able to build high chairs and maintain a website chronicling his lifestyle.

Once this show aired, Thornton received worldwide attention and attracted the ire of U.S. Sen. Tom Coburn of Oklahoma. Coburn demanded that the SSA investigate Thornton for possible fraud. The agency investigated and in August, stated that Thornton had committed no wrongdoing. However, the case resulted in greater attention being paid to potentially fraudulent claims.

Other agencies have experienced similar types of fraud. Recently in New York 11 people were charged in a $1 billion disability claims fraud scam for allegedly helping hundreds of railroad workers file false disability claims since 1998. The 11 defendants worked for the Long Island Railroad and were covered by the Railroad Retirement Board. The investigation was initiated in part because the company had an alarming number of disabled retirees - 97 percent of the company's retirees applied for disability. The claims varied from back injuries to carpal tunnel syndrome, yet the investigation found that many of these workers kept active lifestyles, including playing regular rounds of golf and tennis.

There are even more examples of disability fraud. During an investigation of federal employees from the period October 2006 to December 2008, over 1,500 federal employees in three different agencies were found to be receiving disability benefits while still on the job.

The money for claims comes from payroll taxes and general tax fund revenues, depending on the type of disability benefit received. When individuals fraudulently receive benefits, they limit the funds available for those who are actually disabled.

Although the vast majority of SSD claims are legitimate and provide badly needed benefits to individuals who can no longer work, these highly publicized examples of disability fraud have had an unfortunate effect on the SSD claims process. The most obvious consequence is that the length of time required to obtain benefits has increased. Some disabled workers do not receive benefits until two years or more after the initial SSD application, in part because of the scrutiny claims receive in an effort to limit fraud.

Because of the increased volume of SSD claims and the need to limit fraudulent payments, claims are being routinely denied in the hope that the disabled worker will simply give up and not pursue benefits that he or she paid for through payroll deductions. That is why it is critical to have a knowledgeable SSD claims advocate to assist when seeking benefits. He or she can help you avoid red flags that could inadvertently put your claim in the pile marked "deny" and guide you through the process.

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