A Baltimore man was sentenced in federal court for Social Security disability fraud, federal health benefit program fraud and health care fraud. While Social Security disability insurance (SSDI) fraud is not uncommon, one element of this case makes it more noteworthy. The man was employed full time by the Social Security Administration (SSA) as a benefits authorizer for long-term disability benefit cases.
In addition to receiving two years in prison and three years of supervised release, he has to pay over $150,000 in restitution to SSA and Medicare. His attorney says he is appealing the sentence, claiming the complexity and vagueness of SSDI work rules left him unsure of what sort of work he could perform while receiving SSDI benefits.
The case, like that of many people receiving SSDI, is complex. He developed AIDS in the mid-1990s and was determined to be permanently disabled by SSA in 1996. With the help of new drug therapies, his medical condition improved enough that he was able to perform limited work, until his condition worsened in 1999.
He was contacted by SSA in 2004 and asked to participate in a new program that would enable some SSDI beneficiaries to return to work. In 2007, he was hired by SSA to work as a benefits authorizer.
His attorney said he did not understand that he could not receive SSDI benefits at the same time as he worked full time. There are strict limitations on what, if any, work SSDI beneficiaries can perform. Part of the confusion may stem from the fact that until there is a “cure” for AIDS, his disability determination cannot be reversed. His attorney is appealing the verdict and his sentence.
Source: Department of Justice, “Baltimore man sentenced For Social Security and Medicare fraud,” January 3, 2013