September 30, 2016

Payment Processing Mistakes Made by Social Security Result in Accusations of Claimant Fraud

SSD overpaymentsYou are going to be hearing a lot about Social Security disability fraud in coming months.  With the disability trust fund about to run out of money, Congress will find itself moving money from other programs into the disability fund to shore it up.

With their attention drawn to the disability programs, legislators will demand more accountability from Social Security administrators.  Fraud against the program will be a focus.

A recent USA Today story about fraud was entitled Feds: 36,000 Get Improper Disability.  The news article cited a GAO report showing that Social Security issued $1.3 billion in disability payments to people who had jobs from December, 2010 through January, 2013 and that Social Security is going to aggressively pursue recovery of these overpayments.

According to the news story Social Security has trouble tracking earnings during the five month waiting period applicable in SSDI claims.  Claimant earnings did not reach the wage-earner’s record and Social Security issued payment for months where an approved claimant was not eligible.

While this USA Today story and others like it are sure to inflame the passions of those who are convinced that 80% of disability claims are fraudulent, the truth is a little less newsworthy.

First, while $1.3 billion amounts to a lot of money, in the land of Social Security, $1.3 billion represents less than 1% of disability payments made to less than 1% of beneficiaries during the 25 months of the GAO report.

Further, I suspect that many of the overpaid claimants had no idea that they were receiving payments for which they were not eligible.  Social Security payment letters – which inform approved recipients how much they will be receiving and for what period are complicated and confusing.  I regularly get calls from clients – many of whom have a high school education or less – asking what all this paperwork means.

If the approved claimant also applied for Supplemental Security Income, he will get a letter advising him that he was approved and then a day or two later a second letter stating that his SSI benefit will be fully or partially offset.

The five month waiting period is also poorly explained.  The rationale for this waiting period is not explained nor is it explained that five months means five full months, with partial months not counted, so five months usually means five and a half months.

Finally the payment letters also attempt to explain the Medicare benefit and how it kicks in on the 25th month following the first payment.

All of this information is necessary, of course, but to a non-lawyer who is in pain or otherwise uncomfortable (after all an approved claimant by definition does not have the capacity to work), it is not at all surprising that payment processing errors made by Social Security are not picked up by claimants who have been struggling to survive during the 2 years it takes to get a decision.

So, before the politicians and commentators proceed to attack disability recipients for acting fraudulently, they should take a few minutes to understand the process from the point of view of the disability recipient.

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Jonathan Ginsberg represents Social Security disability claimants in Georgia. In practice for over 29 years, Jonathan publishes a widely known disability blog, a podcast and several disability web sites. In 2004, Jonathan published a "how to" book about Social Security disability called the Disability Answer Guide. Jonathan lives with his wife and 2 children in Atlanta.

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