Federal Disability Benefits and Fraud Allegations

Author: Agnes S. Wladyka, LLC
Published: 2013/11/08
Category Topic: Disability Benefit Cheats - Academic Publications

Page Content: Synopsis - Introduction - Main

Synopsis: Recent fraud allegations could result in longer wait times and higher denial rates for SSDI and SSI disability claimants.

Introduction

Main Content

Recent high-profile allegations that federal disability benefit programs like the Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs are wracked with fraud could lessen the chances of benefit awards for applicants with legitimate illnesses.

Allegations of fraud in the system are nothing new, but a recent profile on the television news show "60 Minutes," (that disability advocates are calling "sensationalized" and "misleading") as well as a recent Senate subcommittee report highlighting a fraudulent scheme perpetrated by an attorney and judge in Kentucky could bring backlash that further slows the already lengthy disability application process.

It is the "60 Minutes" piece in particular that led Rebecca Vallas, co-chair of the Social Security Task Force at the Consortium for Citizens with Disabilities (a group representing more than 100 state and national disability advocacy programs) to proclaim that the news show "perpetuated myths and stereotypes," "did a tremendous disservice to...people with disabilities" and essentially ignored the "millions of people with disabilities who receive benefits appropriately and for whom they are a vital lifeline."

Other disability advocates echo Vallas' statements, pointing out that fraud accounts for less than one percent of the benefits paid out by these programs. A common fear expressed is that the backlash against misguided news pieces and sensationalized Congressional investigations will result in wrongful denials of applications by legitimately disabled people who desperately need the benefits to which they are entitled under federal law.

The current application system

Currently, it is already tough to qualify for and receive an award of disability benefits under either the SSDI or SSI programs. An application is only accepted after a five-month waiting period following a disability diagnosis, must be exactingly filled out and there must be ample medical evidence proving that the applicant is unable to work. Furthermore, an initial determination following an application can take up to 90 days, at which point a great majority of applications - about 70 percent - are denied. This doesn't mean that those people are not entitled to benefits, but a small technical error, missing document or other reason could lead to a denial.

Appealing a denied application

Thankfully, there is an appeals system built in to both the SSI and SSDI programs.

After an initial denial, an applicant can file for reconsideration of the decision; if that fails, then a full appeal can be filed. It is at this stage in the process that many applicants who had filled out the initial application by themselves now retain an experienced social security disability attorney.

The appeals process can be tricky to navigate, will have another lengthy waiting period and will likely involve a hearing before an administrative law judge specially trained to handle disability matters.

Studies have shown that while an attorney isn't necessary to file a benefit application or appeal of a denied application, those applicants represented by counsel are statistically more likely to succeed. Whether you are just beginning the application process or are ready to appeal a denial of benefits, seek the advice of a skilled social security disability attorney.