Jun 9, 2015

Busted!

     I have written before to warn that some comments on this blog appear to have been authored by a person or person who pretends to be a current or former Social Security employee with actual knowledge of conditions at Social Security. There are a fair number of these posts which ring false to me but I only call out those that go beyond implausible. Here's one:
One case I remember was a mother receiving SSI benefits for a year and a half for a child she had given up for adoption at birth. Benefits were ceased for failure to cooperate. I had the case at the recon level (of course Mom asked for benefit continuation) and discovered this to be the case when I wrote to the hospital where the baby was born and the pediatrician they sent records to. Not only was there fraud on her part but her parents and other relatives withheld information.
     Let me list the problems here:
  • How does the birth mother get SSI benefits for a child she gave up at birth? The child would have to be quite sick. How would the birth mother know what was wrong with the child? How would she know where the child was being treated? Without this information, the birth mother can't get benefits. I can imagine the possibility of an open adoption where the birth mother would have some of this information so I'll just call this improbable.
  • Doesn't the disability examiner notice the adoption when reviewing the medical records at the time the claim is filed? I have seen medical records on sick children. Pediatricians pay attention to the parents of sick children and mention facts like adoption in the medical records. In the case of a very sick child, I'm expect that adoption would be prominently mentioned in the medical records. Maybe the disability examiner missed this but it's improbable.
  • Why would benefits be ceased for failure to cooperate a year and a half into benefit payments? Normally, a denial for failure to cooperate is something that happens when a case is first being adjudicated. This could happen but it's another improbability.
  • The person writing this is posing as a current or former Social Security field office employee but says that he or she wrote to the hospital where the baby was born. That's not something that field office employees do. It's hard to imagine why the field office employee would even want to do this. This one is highly improbable. It sounds like it was written by a person lacking a firm grasp of the role of the field office versus the role of disability determination.
  • Most important, there's no benefit continuation for a failure to cooperate cessation. This one is beyond improbable. It's impossible. Even if benefit continuation did exist for this circumstance if the birth mother could ask for benefit continuation she could certainly avoid cessation for failure to cooperate. Again, this sounds like it was written by someone who lacks a firm grasp of basic Social Security law and procedure.
     Be careful when reading comments to this blog. Some commentators are pretending to have knowledge they lack. This seems to happen every time I write about anything relating to the incidence of fraud at Social Security. The poseurs could be Congressional staffers. They could be "think tank" employees. They could simply be paid shills and, yes, people are paid to write comments like this on blogs and newspaper articles. Posing as a government employee with inside knowledge is a common tactic.

12 comments:

Anonymous said...

It does seem a little fishy, but I'll play devil's advocate and counter your assertion about a child just born getting benefits:

remember that if the child was born under a certain weight, that's all the medical evidence one needs to find either medically-equals the growth impairment listing or extreme limitation in domain six. In fact, being found disabled right at birth makes me believe it's a coin flip that the kid was low birth weight or had serious congenital defects, both of which wouldn't really require much more than the first few sheets of paper created after birth.

Anonymous said...

As a state DDS examiner I agree with 10:27 that although it may be fishy, it may also be entirely true with the following scenario:
The child was allowed with one page of evidence from the hospital submitted with the application through expedited procedures. This page shows that child was born premature and under 1200 grams at birth. There is no other medical info on these forms that are routinely created by the hospital. (The child is probably still inpatient at the NICU)
This receives a 1 year diary.
At initial CDR a year later, the mthr failed to cooperate for whatever reason - didn't submit info or didn't attend CE and child is ceased.
Mthr gets cessation letter and within 10 days files appeal with request for benefit continuation which is allowed (even for failure to cooperate).
This person gets the claim on CDR recon and then requests and receives hospital & txing source records which were not previously in file documenting the adoption. (Nothing in the quoted statement indicates that this individual is an SSA employee rather than DDS employee.)

Anonymous said...

I am with the above. Hospitals are very aggressive about filing SSI claims for low birth weight infants in order to make sure that they have medicaid coverage for their very high medical expenses. A little know if fact is that even infants with affluent parents qualify because in the SSI world view, an infant born in a hospital is not living with his parents until he goes home from the hospital. Some parents are not even aware that their child was briefly eligible for SSI and medicaid until after the infant is discharged.

Anonymous said...

Exactly as the previous anonymouses pointed out. The child was born with a chromosomal anomaly evident at birth. She was either low birth weight or required a major surgery (I forget -it was several years ago) and so was allowed under one of these cataegories rather than for the chromosome abnormality since at the time they made the decision the karyotype was not back yet. At the initial CDR the mother of course did not give any new sources--hence the cessaton. I --and I have never known a field office rep to write to a medical source so I do not know why anyone would think I was misrepresenting myself as a field office employee--wrote to the birth hospital in hte belief they would now have the chromosome studies and the child's benefits could be continued. As also said above--benefits are continued even in FTC cases if it is requested in 10 days.
That said, I do not believe there are huge amounts of fraud..just that this was such an egregious case and I never heard what if anything ever came of it. Sometimes people say how ridiculous it is to re-evaluate people who are completely paralyzed, have amputation of multiple limbs and I always think of this example--to see if hte person is till alive and is the one getting the benefits rather than someone who knew them at some point in time.
So where can I get paid for writing this kind of stuff??

Anonymous said...

Hmmm, should SSA employees be talking about the medical facts of claimants on a public blog?

Anonymous said...

Hmmm, do you see any identifiable information posted? Hmmm? Or should it be duhhh.

crave free stuff said...

Crave Freebies for world residents are listed here. Updated daily. Click Here Free Stuff to see the latest Free Samples offers.

Anonymous said...

Sadly, I concur with the above statements. My years with the agency showed the above actions valid and entirely consistent with SOP at DDS. The agency always gives the claimant (and here the parent) the benefit of the doubt, and the child is held separate.
As the laws regarding adoption vary by state, I can attest that in the states I worked NO adoption info could be put into hospital MEOR. Those items would be found separately, usually in the nursing notes which are kept separate from MD record. DDS does not request nursing records, as they are deemed an invalid medical source.
Adoption info most likely found in the pediatric primary care record months after the baby was discharged from the hospital.

Anonymous said...

Now Charles, you're tipping a wee bit into paranoid conspiracy theory now aren't you?

Anonymous said...


[Hmmm, do you see any identifiable information posted? Hmmm? Or should it be duhhh.]

It's generally dumb for any SSA employee to blab medical facts they know about claimants to the public, even if they leave out names or SSNs. It's quite possible that you might blab enough information to tip off someone in the public to the identity of the person you discussed. Consider the example of the imprudent fellow at 2:32.

He discloses a general time frame the child was born. He discloses the claimant child had a rare genetic chromosomal condition and a low birth rate. He discloses the child was awarded SSI benefits, and that they were paid to the birth mother instead of the adopted mother. He discloses he works at a SSA office. A traffic monitor on a website can locate where he posted from which is likely near the SSA office he works at. Thus, he has likely outed the child's location within a fairly close range.

With that information alone it may be possible for some people in the public to identify the person. For example, people at the local adoption agency or hospital might remember a child with a rare medical condition and low birth rate born in a certain time frame. Other family members might as well. With a little more information and digging plenty more people might identify the person courtesy of the loose-lipped SSA employee. Since disclosing such information is potentially a federal crime, it is remarkably dumb for any SSA employee to risk it.

Anonymous said...

There is no way for anyone to tell who that specific (baby) recipient was - even if someone could actually pin down the IP address. That case happened years ago and the commenter introduced a bit of randomness by not completely remembering the facts. I'm pretty sure there was NOT just one baby that was born premature with a chromosome disorder in that area in the past few years. The commenter is fine! I am a former SSA employee (in a Research office - nothing very useful to the public - lol) and specialized on the OASI side. So, hearing examples like this allows me to learn more about the DI side. It's wonderful! Thanks for the thorough discussion everyone! Hopefully, there will be an "I Could Have Been Wrong" post in the near-future.

Anonymous said...

12:28

your paranoid worry scenario requires at least one very clear instance of improper dissemination of PII before the public could figure out who the commenter was talking about ("SSA employees with loose lips"). If your scenario requires a clear, no questions asked, PII violation by somebody else later down the road in order to make the original information dangerous, the original information is not dangerous.