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Fraud allegations and SSDI

Many of our clients here in Ohio were no doubt cringing at the thought of what may come of the most recent fraud incident involving the Social Security disability insurance (SSDI) program.

Sadly, while Congress has mewed and dithered when dealing with the banking industry, which engaged in fraud at a scale so large that it came perilously close to causing a meltdown of the entire U.S. economy.

However, when they come across some incident involving alleged fraud and SSDI and unemployment benefits and the congressional cross-examinations become withering and demands are made to "fix" SSDI, where "fix" really means to "cut."

Fraud within SSDI, or any program or system, is a problem. Nevertheless, SSDI is not uniquely afflicted. Private insurance companies probably spend millions of dollars dealing with fraudulent claims.

The relevant question is how to best prevent it. Cutting benefits to disabled workers with legitimate impairments is not the answer. Perhaps Congress should begin by adequately funding and staffing the SSA's administrative law judge division. Allegations have been made that some ALJs merely rubberstamped the approval of some benefits.

During the last decade or so, the SSA had developed a severe backlog of claims determinations. Some resulted from broadening eligibility requirements for SSDI and some from the lack of sufficient funding for much of the SSA's administrative functions.

The SSA's ALJs may have approved some SSDI appeals with inadequate examination, but the ALJs have countered that they faced intense pressure from the SSA management demanding they process more cases to reduce the backlog.

Fraud investigations are expensive. Congress has to face facts; either they fund the SSA so it can accurately investigate potential cases, or it will have to rely on the U.S. Attorney's Office to prosecute the cases after the fraud has occurred. 

Source: The Wall Street Journal, "Disability Fraud Bust Comes as Social Security Agency Is in Flux," Damian Paletta, January 7, 2014

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Philip J. Fulton Law OfficeRepresenting Victims Of Workplace Injuries And Disability

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