How common is SSDI fraud?

Reports of Social Security Disability fraud seem to come almost weekly these days.

These reports have increased attention to the disability program and led to claims that the Social Security Administration’s program is rampant with fraudulent claims.

A recent story about New York firefighters making fraudulent claims has helped fuel the debate over SSDI fraud and claims that fraud is the only reason why disability claims have increased in the U.S.

Despite the media’s claims that the disability program is rampant with fraud, that is simply not the case according to a recent report by the executive director of the Consortium for Citizens with Disabilities and a vice president of Easter Seals.

The report points out the exacting requirements necessary to prove that a person is disabled under SSA.

To win an SSDI claim, a person must first have worked enough to qualify for benefits, have a severe medical condition that limits their ability to function proven by extensive medical records and reports, and must be so limited that they cannot perform their past work or other available work.

To say that obtaining Social Security disability benefits is hard would be an understatement.

According to the report, less than four in 10 (or 40%) SSDI claims are approved.

And, those that do receive SSDI benefits receive only a modest monthly benefit which averages only $1,130.

These funds must be used to pay for living expenses, medical care, food, and other basic necessities of life.

While the overall number of Social Security disability applications has increased over time, according to the report, the reasons for the increase are many and varied but mostly result from three things:

  1. Overall population growth
  2. Baby-boomers reaching the age where disability is more likely
  3. Entry of a greater number of women into the workplace in the 70s and 80s.

That is why the claim and reporting that the disability program is full of fraudulent claims is so disheartening.

I see sick and disabled individuals every day that need the benefits that they paid for throughout their working life.

Having these individuals cast into the same light by the public and the media as fraudsters only serve to further marginalize and stigmatize people at their lowest point.

Does fraud exist in the SSDI program?

Yes, that cannot be denied and they should be rooted out and face the consequences of their actions.

But, fraud is not as widespread or endemic as some would have you believe.

A few outliers that receive all the attention does not make the entire program a sham.

The small number of fraudulent claims should not be used to justify wholesale changes or further limit access to the necessary and vital benefits.

How Social Security Disability Fraud Hurts Everyone

A recent news article about an ex-postal worker sentenced for worker’s compensation fraud caught my attention and bears mentioning in this blog.

First, let’s talk about the ex-postal worker. She was a Florida resident and reportedly injured her back during the annual Letter Carrier’s Food Drive in 2009. Due to her injuries, she alleged that she could no longer deliver mail. She was relieved of her mail carrying duties and placed on “light duty” work. During this time, she collected worker’s compensation benefits since her pay was reduced due to the lessened responsibilities.

However, evidence—including videos and photographs—showed that this allegedly injured worker competed in 80 long-distance races including marathons and triathlons following her injury. According to news reports, her times improved after her injury. A federal jury convicted the allegedly injured ex-postal worker of health care fraud and making false statements to collect benefits. She faces up to 15 years in prison and will be sentenced on July 25.

While this case was a worker’s compensation case, its message and repercussions will be felt throughout many other programs.

As a Social Security disability attorney, cases like these are disheartening to me for a number of reasons.

Mostly because I know that most benefit recipients (whether worker’s compensation or disability) are truly in need of the benefits.

They are not stealing from the system, but relying on the system.

But cases like these are used by those in power to make it much more difficult for truly injured or disabled people to get benefits.

Can you Turn Someone in for Social Security Disability Fraud?

I know that in every system there will be those who abuse and steal from it for their own personal gain, and I am in full favor of rooting out such fraud and punishing those who abuse these much-needed systems.

To report suspected fraud, you can fill out an online form here.

Loyd J. Bourgeois
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Nationally recognized attorney dedicated to fighting life's legal battles with compassion and care