Mar 12, 2016

Two New Rulings Coming Monday

     Even though it's in the middle of adjudicating about 1,500 cases of alleged fraud or similar fault, the Social Security Administration is issuing two new rulings on Monday, one dealing just with  the issue of similar fault and the other dealing both with fraud and similar fault.
     I don't know how much good it does to so conclusively demonstrate that you're changing the rules for one specific group of cases. It's like they're trying to bootstrap a weak case.

14 comments:

Johnny Cash said...

"An individual may appeal our finding of fraud or similar fault. However, we will not administratively review information provided by SSA’s Office of the Inspector General under section 1129(l) of the Act regarding its reason to believe that fraud was involved in the individual’s application for benefits."

So OIG's decision is untouchable? What happened to the concept of due process?

Anonymous said...

That's not how I interpret that section but this is the government at its best, so who really knows!

Tim said...

It's a page out of Roger Goodell's playbook! If you believe the NFL, read the 15 Myths of Deflategate. I only bring it up because of the interesting parallels: A powerful organization prejudged a "scandal" and made their rulings based upon an "independent" "investigation" that was politically motivated. ASSUMPTIONS were made that put the "villains" in the worst possible light, hinging on supposition of a scheme to "cheat" without any real evidence of wrongdoing. After a year of LIES, changing of "rules" expost facto and smearing of the "villains" to the willing press, the only possible "PROVED" WRONGDOING was by an employee of the organization (SSA ALJ and NFL employee who passed off kicking balls in games as game balls, so he could sell "GAME BALLS" on ebay). The difference might be that there could be some truth behind SSA's allegations, but they should have to prove it! Deflategate: 100 percent FARCE. HOWEVER, as George told Jerry on Seinfeld, "It's not a lie... if you believe it!"

Anonymous said...

Agree with 5:18. Think of OIG's referral as like a traffic stop, and the redetermination procedure as the subsequent search of the stopped vehicle for contraband. That provision is saying that you cannot challenge the reason for being stopped (unlike in an actual criminal case), but whatever findings SSA makes after its search are fair game. For instance, OIG might find (in its view) evidence Dr. X has given out fraudulent disability opinions. So SSA decides to redetermine anyone in pay status who has evidence from Dr. X in the file. SSA is not going to let you litigate the adequacy of OIG's investigation, the information they used to reach their conclusions that Dr. X has acted fraudulently, the selection of your case for redetermination, etc. You can, however, argue that Dr. X's evidence in *your* case should not be considered fraud/similar fault, and if SSA decides to the contrary, you can appeal.

Anonymous said...

DO we have to bring the Cheatriots into this?

Tim said...
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Anonymous said...
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Tim said...
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Anonymous said...
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Tim said...

Whatever...

Anonymous said...
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Tim said...

Would you apply that to Eric Conn? He found doctors who were willing to give his clients the paperwork they needed and got a willing judge to approve his clients' claims. I do believe its possible that many of Conn's clients didn't meet the threshold standards for disability, but the blame for that should be on SSA for allowing an ALJ to approve that many cases and not having a control system to prevent it. Likewise, they don't have a real system in place to insure that actually disabled people aren't denied by denier judges or made SOL by doctors unwilling to support claimants that they admit they can't help get back to work! This especially true in areas where there just isn't real competition to get a second opinion.

Social Security News said...

There are other places for arguments about football. Let's keep the comments somewhat relevant to the topic.

Tim said...

I was only comparing them in a legal sense.