Category Archives: Social Security Fraud

Your Disability Case is Just a Money Grab Bag for some Disability Firms! SSD in a Nutshell Series Blog #5

canstockphoto32474085-1Most people seeking help with filing a disability claim turn to the internet for information.  A quick Google search will offer up loads of links for “Disability Advocates” that will provide a “Free” review of a person’s case to see winning benefits is possible. The prospective disabled client enters his or her contact information into the site contact form and answers a few questions. The information is forwarded to disability advocates and lawyers who pay for this information. There is nothing wrong with this practice and it puts many people in contact with excellent advocates that can win cases. As a matter of fact many other legal services professionals utilize this type of promotional tool to obtain clients

A problem arises when this information is improperly distributed and when firms purchase more contacts than they have staff to properly process.

Leads Companies:

Companies that publish these websites and gather information usually agree to give information (leads) to only one attorney or advocate at a time.  In other words, if you enter your information into a site, your information should only be sent to one of the website company’s clients. It is important a person does not enter his contact information into more than one site to avoid causing his own tidal wave of advocate firms calling him.Yet, some of these website companies provide information to several of their clients. This results in a barrage of calls, emails, texts, and mail from several advocate companies being sent to one person in an attempt to obtain his or her case. It is very overwhelming on the prospective disability client to receive all this information and try to sort out which firm to hire. A person entering her information into one of these sites can see 15 text messages and calls from advocacy firms in one day that want to take her case. It is important to read the fine print on these websites to see who is collecting the information and why.  The website should indicate that it is gathering contact information to provide a law or advocacy firm and by providing information the prospective client is agreeing to be contacted by a representative of that firm.

It is important to understand SSA will not text anyone regarding an application for disability and demand the person call the number in the text to “complete” the application. (SSA may send text messages but only if specific steps are taking by the individual to receive texts specifically from SSA). Some of the firms that go overboard in contacting prospective clients purposely imply they are the SSA.

The advocate firm representatives that contact the prospective client by phone should not sound like they are reading from a script or be calling from outside the US. They should clearly state they are NOT the Social Security Administration and that they wish to represent the prospective disabled client in his her or claim and will charge a fee for doing so.  These companies should also immediately honor any request to stop communications.

Disability firms that abuse leads information:

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It is very hard for disability advocates to make money in this practice.  Fees are relatively low compared to the average legal fee that lawyers receive for services. Disability advocate firms can struggle with making a profit and maintaining ethical standards of serving clients. Despite this fact there are many disability firms that succeed in this balance and help many disabled people get their disability benefits. There are too many firms however, that skip the ethics for fast and large profits. These firms operate with the perception that in order to profit they must gather mass amounts of cases and invest the least in staff and processing of these cases.  These firms employ a limited number of qualified staff and the lion’s share of the work and case processing is left to entry level workers.  These workers receive limited training in filing forms and gathering information from the clients and are buried under hundreds of cases. Without the constant guidance of an experienced advocate these workers can quickly get overwhelmed and quality of case management suffers. Progress with client cases gets delayed and the risk of a denied claim is actually increased.

When someone files for disability he is usually in dire need of the benefits and deserves to see his case approved as quickly as possible. Hiring a bad firm could mean that it could take several weeks from the firm receiving the documentation from the client to actually getting the case filed with SSA.  If a case gets denied these firms are often behind in filing appeals meaning cases will sit until the 60 day deadline is near.  This can easily add  an unnecessary 4-6 months to the already long disability process.  Further adding to these delays is failure to respond to SSA and follow up on case processes to ensure proper processing of the case.  There are unique and often complicated details that arise in each case that if not addressed can mean the difference of winning or losing the case. A disabled person is better off without an advocate than hiring a firm that operates like this.

Websites, advertisements, and familiar names are not guarantees of great advocacy for a disability case. A good place to start is to search online for complaints.  One must keep in mind that even the best company will have had disgruntled clients from time to time. However, long lists of complaints with a common thread should be seen a red flag that the firm does not put its clients, first. These can be:

  1. Clients complain of their case being assigned and re-assigned to several case managers at the firm in a short amount of time.
  2. Clients cannot get someone on the phone, are put on hold for long periods, or do not receive returned calls.
  3. Clients complain that despite having submitted needed documents the firm takes a long time to get cases filed and information submitted to SSA.
  4. Complaints of poor customer service such as a lack of compassion from case managers or not getting help when its asked for.

If a disabled person is not well serviced by her advocate she can dismiss the advocate and hire someone, new. The previous advocate cannot charge a fee for the work they have done without specific approval from SSA.  The previous advocate must show that a very significant amount of work was performed properly on the case to be allowed to charge a fee. In many  of these cases, the previous advocate will not be able to show SSA they deserve a fee for work prior to the client firing them.  An advocate cannot prevent a client from dismissing them.

There are both attorneys and non-attorneys that do an excellent job advocating for the disabled and winning cases.  In this work, being an attorney does not necessarily make the advocate better than someone who is not an attorney. Organizations such as NADR and NOSSCR can put disabled persons in direct contact with a qualified representative in good standing via their referral services  These services can also assist in finding a local advocate which is sometimes preferred over an advocate far away.

More will come on this issue as I am very passionate about fair and competent representation of disabled persons. Please feel free to comment below or ask me questions!

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Filed under Basics of Social Security Disability, Disability Advocates, Medicare & Medicaid, Social Security Fraud, SSDI, SSI, Uncategorized

Why Do So Many People Who Should Not Get Disability Get Approved for it? SSD in a Nutshell Series Blog 2

canstockphoto15449778The Social Security Disability Program is difficult to navigate and understand. Adding to those difficulties is the perception there are mass numbers of people receiving benefits that should not be. The purpose of today’s blog is to explain some of these misconceptions.  Indeed there are people receiving disability benefits that should not be. However the reality is not as bad as it seems.

“I know of people who are getting disability and there is not anything wrong with them!  Why is it so hard for me to get approved?”, say many people I talk to.

Most claimants have some if not a lot of difficulty getting approved for benefits.  This is especially frustrating for people who have worked hard most of their life and get denied disability despite strong medical evidence. Some cases that get approved seem that they should not have been.  The disparity between which cases get approved versus those that do not has many factors.  The reasons could be the region the claimant resides, if he had a good advocate or not, agency error on the part of SSA, just to name some.

The trend of a higher percentage of cases being denied compared to a decade or so ago is very real.  There are people getting benefits who were approved when it was easier to do so versus getting approved, today. If these same individuals were to apply for benefits now, they would have a higher likelihood of being denied.

The recent economic downturn forced a higher number of people to apply for disability. Employers who could no longer afford lower productivity from challenged workers. Of course these workers were among the first to go. Many of these people are from the older population not yet eligible for retirement but have extreme difficulty finding new work. Combine that with today’s tighter scrutiny on SSA’s approved cases and it is simply more difficult to get approved for disability these days.

The Hidden Disability: “You get disability?  You don’t look like there is anything wrong with you!” say many people to my client with lupus.

A very misunderstood population is sufferers of ‘hidden disabilities’.  Hidden disabilities can include the following conditions that may not cause many visual symptoms.  These could be:

  • mental disabilities
  • chronic pain and fatigue disorders
  • lupus and other autoimmune disorders
  • diabetes
  • neurological disorders

These conditions have manifestations that effect each sufferer, differently. A person suffering from lupus may experience symptoms during periodic flare-ups.  Perhaps she feels generally well for a month or so and functions normally. But when her symptoms flare she may experience debilitating even life threatening symptoms that can last for weeks or months.  A person that has suffered diabetes long-term may have developed secondary conditions such as diabetic neuropathy, loss of eyesight, and other serious diseases that prevent the person from being able to work on a sustained basis. A person suffering from a severe mental condition may seem fine around his home or familiar environments.  What his neighbors and friends may not know is that he cannot function outside of his comfort zone due to severe anxiety, paranoia, or other severe distress. A disabled person may have good days. If he has more bad days than good in terms of severe symptoms that would cause him to miss a lot of work, he may meet the requirements for disability.

On another note… Social Security (SSA) is supposed to conduct periodic reviews of approved cases to see if claimants have medically improved enough to perform substantial work. As an advocate I have seen many seriously impaired people be reviewed every 3 years by SSA. At the same time, others with conditions that can easily improve over time never experience a review. The process is not a perfect one and I promise to address the issue of continuing disability reviews in a future blog.

There are problems with unscrupulous attorneys, advocates, and doctors along with a margin of error that plague any disability process. Given the uphill battle to win a disability case across the board, most people who are receiving benefits are rightfully doing so.

“I know people who get approved simply because they are drug addicts!”

What? I hear this a lot from frustrated clients and friends. On one hand SSA is not supposed to deny a claimant disability because of evidence of drug and alcohol abuse. Yet substance abuse noted in medical records can cause a person to be denied his disability benefits, unfairly.

This is a tough area of disability and thankfully there are some amazing mental health professionals working with SSA to educate adjudicators and judges on how to recognize severe mental disabilities in the presence of substance abuse.

Simply put, SSA is supposed to consider substance abuse and its contribution if any, to the person’s disability. Consider a person with a severe spinal condition that abuses alcohol on a regular basis. Her spinal condition will not be miraculously cured if she stops drinking. Despite even heavy alcohol abuse, SSA is to consider the actual contribution, if any, of the alcohol to her conditions.  Even if she stops drinking she is very likely still to suffer from pain and immobility. In this case alcohol abuse is not material to her disability and should not be a reason for SSA to deny her disability.

Mental disorders can lead to drug and/or alcohol abuse.  It can be said that substance abuse only worsens the symptoms of mental problems.  However, a person who suffers from severe bipolar disorder may never be able to function normally even if he stopped using drugs.  Therefore, the drug use may not be considered material to his disability. If a person suffers from permanent and severe health problems resulting from substance abuse he  can be found disabled. This may not seem fair on the surface. Alcohol abuse can be due to severe PTSD secondary to being a combat veteran or severe abuse victim.  These sufferers sometimes lack the insight to seek treatment for many reasons. If he was able to stop abusing drugs and alcohol but his physicians believe he would still suffer severe mental symptoms, he should be found disabled.

Despite all the reasoning in the world, our adjudicators and judges are people just like you and me. These people must carefully consider all the facts in cases like these and are expected to be unbiased.  By no means can it be said that a person is given disability benefits simply because she is a drug addict or alcoholic. In my experience it is quite difficult to get someone approved for disability that has drug and/or alcohol abuse in the medical file.

Stand back and consider for a moment…

Most American adults of working age pay into the SSDI program.  Barring a few issues that can prevent a person from having access to his disability benefits, he has a right to his benefits if his conditions render him disabled. We may not approve of someone’s lifestyle or choices but this does not mean that a person should be denied his rights.  That would be un-American.  Not everyone wishes to disclose the reason they receive benefits and when not required by law, many reserve that right.  For example, the neighbor that tells you he is disabled due to a bad back but seems to have no back issues may actually be suffering from a mental illness and does not believe it is anyone else’s business to know that.

It is important not to jump to judgement or let media reports sway you regarding these issues. SSA does not, never did, and probably never will hand out disability benefits to just anyone. Hidden disabilities are very real and can happen to anyone. That said, it is not easy to dupe SSA into giving someone benefits that is not disabled though it does happen. SSA takes very seriously allegations of fraud. If you suspect that someone is collecting benefits due to a fraudulent claim, report it.  Visit SSA’s Website for more information.

Share your comments and questions regarding this blog and I will be happy to respond!

Next up, “What are Some of the Main Reasons a Person Gets Denied Disability?”

©2016 Aaria Consulting, LLC and April L. Roberts.  All rights reserved.

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Filed under Basics of Social Security Disability, Disability Advocates, Social Security Fraud, SSDI, SSI, Uncategorized