Lawyer who represent Social Security disability claimants have always known that the disability system is clogged up with frivolous claims. People, for one reason or another, who file a Social Security disability claim when they know they don’t qualify. Some people file claims even though they’re able to work full-time, and other people file claims even though they haven’t worked long enough to qualify for benefits.
But we’ve also known that many of these frivolous claims are from people who have been forced to file by their long-term-disability insurance carriers. Now word is getting out to the general public about this problem of LTD carriers filing frivolous Social Security disability claims and causing people with legitimate claims to have to wait longer for resolution.
The Dallas Morning News carried a long article about this problem recently. Here are excerpts from the story:
The Social Security system is choking on paperwork and spending
millions of dollars a year screening dubious applications for
disability benefits, according to lawsuits filed by whistle-blowers.Insurance
companies are the source of the problem, the lawsuits say. The insurers
are forcing many people who file disability claims with them to also
apply to Social Security – even people who clearly do not qualify for
the government program.The Social Security Administration
defines "disabled" much more stringently than the insurers generally
do, so it rejects most of the applications, at least initially. Often,
the insurers then tell their claimants to appeal, the lawsuits say,
raising the cost.The insurers say that requiring a Social
Security assessment is a standard practice and that there is nothing
wrong with it. The policies they sell allow them to coordinate their
benefit payments with others to make sure no one is paid twice. Thus,
if a disabled person can get benefits from somewhere else – like
workers’ compensation, a disability pension or Social Security – the
insurance company can reduce the benefit check by that amount.The
flood of referrals, however, is making it hard for Social Security to
respond to people who are truly disabled, said Kenneth Nibali, the
former top administrator of the Social Security disability program."Anybody
who is forced to come into this system, and who doesn’t need to be
there, is affecting someone else," said Mr. Nibali, an expert witness
for the plaintiffs. "They’re holding up cases for the people who have
been waiting for months and years, who in many cases are much worse
off."The number of people waiting for hearings on their
disability claims by an administrative law judge has more than doubled
since 2000, and the average wait has grown to 512 days in that time,
from 258 days.
I’ve gone round and round with them. My husband is a T-11 para incomplete as a result of a spinal epidural abscess which left him paralyzed from the waist down with complete loss of bowel and bladder function. Yet, because I as his spouse make too much money, he’s not eligible for disability benefits. And because as a taxicab driver he never paid into the system, he cannot avail himself of any of those benefits either. (Let THAT be a lesson to all those out there who work for cash thinking that a bird in the hand is worth two in the bush!)
Yet it galls me that so many people who clearly COULD work, who CAN walk and CAN function are collecting disability. Grr.
Well, as a legal secretary, I’ve heard my boss say many times, “It’s a legal system, not a justice system.”
I’m very sorry to learn of your husband’s problems. From what you’ve written, I doubt we could help you, but we’d be glad to visit with you if you want to call us.
You make an excellent point about cash workers. If you don’t pay into the system, you can’t qualify for benefits.
I just turned 50. I am an “Unemployable” Veteran on disability and applying for SS disability. My list of conditions takes a page, suffice it to say I have widespread OA, am 2 inches shorter from spinal compression, bad back-head to tail, Chronic Fatigue Syndrome (CFIDS),bad knees,bad shoulder, loss of peripheral vision, hearing loss, severe DJD in both feet (one recently operated on)OA in both hands, GERD from pain meds, liver function problems, Depression,ADD and more.
I am having difficulty with the system because as my first SS medical reveiwer wrote, “He is going to online school instead of looking for work.”
OK, so if I try to find work by education in a way that actually allows me to attend classes without more concern about physical limitations, I am not trying to work?
I have not been able to meet job productivity requirements for more than 3 months at a time of 5 day a week work – and I worked in Rehabilitation!
Yet, SS says that if you can work anything for [it seems even one day] you are not disabled.
I got a further comment,”….the way you describe your job,yes, you could not do it, BUT- (remember this is in healthcare)the way MOST other practitioners describe the job you could continue to do it….
So, by being ethical, in not “paperwhipping” a treatment or in providing a “cookie-cutter” hand out sheet and some instructions – this is considered a “standard of care”?
How do I approach the upcoming hearing and not become adversarial on this point?
The other factor is that I do have an increasing amount of “cognitive processing deficits” coming into play – word finding,concentration, time management because I have to double check myself for entry errors, calculations, or even basics of diagnostic criteria. These were never “documented” on efficiency ratings, just a lot of informal “chats” with my supervisor because I was trying to stay employed. I was let go twice because I was “not productive enough” secondary to my continuing “disabling conditions” – which I was upfront about with all employers. I could never tolerate “stupid” people in the healthcare system and then I became one, and felt ethically required to retire my license.
I tried internet marketing, I still “try” but so far my “income” has been all negative except for a grand total of about $500 for the year of 2007. These are what a “college educated person SHOULD be able to do….” How does one document, attention to detail missing so business not such a good idea?
Again, how do I avoid being “adversarial”?
(By the way I am not always even this well organized and to the point, so please forgive my inability to state in “100 words or less”)
I really feel for some of the other posters here, especially the family with the man with paraplegia – I went through some of that with my mother. I would be willing to share some further sources of information on agencies that focus on assistance to those with that set of needs.
Unfortunately, we hear stories like this Alost daily. It’s shocking how many people are in horrible financial situations because of the sad state of our disability system.
If you want to discuss this further, please call our office and we’ll be glad to visit with you.
Robert A. Kraft
Kraft & Associates
Injury, Disability & Immigration
2777 Stemmons Freeway, Suite 1300
Dallas, Texas 75207
(214) 999-9999
(817) 999-9999
(800) 989-9999
mailto:rkraft@kraftlaw.com
http://www.kraftlaw.com
Although completely eligable for SSD according to SSD standards I was refused and had to hire and attorney who after signing a contract for the alotted amount to bill waited until outside the courtroom on the hearing day to demand a higher percent or “I have to find another attorney to represent me and that will delay my case considerably”. That was blackmail but I had to sign. Years had gone by without income. I was turned down by a Philipine justice temporarily brought into ease the backlog. I fired her and hired another attorney. He also signed a contract for the allotted amount allowed by ssd to bill. After my case sat for three more years I won. Now after the fact he applied to the court and an administrative judge gave him and HER five thousand dollars extra on top of the alloted fee for all their work. Excuse me but they both signed a contract. And now the Lawyers in NY have found a new scam to get money to each other. They have found a way to circumvent the Federal governments limits and give each other more money!! SSD needs to be handled not by attorneys but by state salaried employees. Lawyers are not needed to gulp up greedy sums off the disabled.