Doing this actually occurred to me years ago. Sometimes you help a claimant get on benefits but you know from their medical records that they're getting better and have a realistic chance of returning to work. It doesn't happen much but it does happen. Since you already have their medical records, you're in a great place to spot these cases and to profit from providing "rehabilitation" to people who need little help anyway. I never did it because it seemed like a conflict of interest or at least it didn't seem to smell quite right. It's not illegal, though, as far as I know. Of course, I don’t know how Allsup is coming by its TTW cases.
I wonder if there are other affiliates of entities representing Social Security claimants on the TTW list, perhaps with names that can't be so easily connected.
13 comments:
I don't know that it raises an actual conflict of interest, but it certainly does have a strong ambulance-chaser vibe, doesn't it?
Allsup gets a very large number of cases from LTD insurance companies. When the claimant wins, they help the LTD carrier collect a portion of the claimant's back award, representing (basically) the SSDI benefit amount for the months that the LTD carrier was paying benefits.
Then, they help the claimant get back to work, which means the LTD company stops paying an LTD benefit. I am sure that makes the LTD company happy. I wonder if the LTD carrier pays Allsup anything on the side for getting its assureds back to work?
@12:02
That would be nice, but timing-wise I doubt that happens much at all. The first two years for most policies, the LTD company pays benefits on the expectation they will get reimbursed by any SSDI award, again in most cases. Then, once the SSDI award comes in, they take their cut and terminate LTD benefits under the any occupation standard.
If the issue that the LTD company just took a ton of money based on SSA's recent award of benefits, they will argue it's irrelevant since SSA has their own standards (yeah, HIGHER), or else the LTD company argues the recent medical report of the "independent" medical "examiner" says the claimant is magically 100% fine.
Getting a claimant to return to work to terminate benefits would be a pretty honest way of doing it, but it's not an honest industry.
@ 12:02
Good point. I knew an attorney who worked with Allsup. He was an attorney so not sure how this is a non-attorney group. But claimants who got LTD were basically forced to file for SSD to offset cases and get on Medicare.
A few years ago, he told me they were getting fewer cases. So he joined a more local firm out here in California.
I have practiced in the SSD field for over 40 years. Early in my career I was contacted by several LTD carriers for client referrals. The cases were excellent. The client were on LTD and there was good medical records. Also, the LTD companies told me I could order medical exams up to $500.00 with no questions asked.
I handled many of these cases for about 10 years. With one major LTD insurance carrier I did about 50 cases a year. At one point, someone from the LTD company called me and praised my work. They said I had won something like 95% of the cases. I was very careful to let the clients know that they were referred to me and that I was their attorney. I also was careful about that relationship with the insurance companies.
At some point Allsup got in this business and my work with the LTD carriers dried up. Allsup's model was allegedly cheaper. I charged 25% of the back benefits and did a professional job. On the other hand, Allsup charged something like two months of the claimant's benefits and did not do as professional job.
Some claimants have broken away from Allsup even though the LTD carrier told the claimants to use Allsup. I have received several of those cases for local clients. The local clients were happy to get away from dealing with a company in Bellville, Illinois when there was a competent attorney two miles away.
Finally, about a year ago I received an e-mail from Allsup. They were soliciting me (and probably a lot of others) to take their cases to hearings in my area. I think they were offering $1,000.00 a case. The terms also involved Allsup keeping control of the case, i.e., medical development etc. I never answered for several reasons. I think that Allsup and other companies and firms like it have hurt local attorneys. Further, I did not want to get involved of sketchy dealings with a non-attorney firm.
The attorneys that accept the $1,000.00 a case deal are losers.
Capitalism
Just as an aside, I notice on their website, they boast a 96% success rate for SSDI cases (impossible, even for the most discriminating attorney) and offer $100 for a referral. Any lawyer doing this would face discipline. Any idea how lawyers can protect ourselves from this?
@9:59
I would expect it's in their footnote language: "*96 percent of the people who complete the SSDI process with Allsup receive awards."
"Complete" is a vague term. I don't think Allsup handles court-work, so it's possible they mean they only drop 4% of claims at the administrative level.
That's twisting the language pretty heavily, but that's the most sense I can make of it.
And you all would do it if you could. Never met a single rep that didnt say thay won over 90%. Admit it, they are doing it bigger and better than you and without a stupid cowboy hat ads running constantly. Now they have found another revenue stream, and you cant duplicate what they are doing.
@11:47
I wouldn't discount a win rate of over 90% out of hand. 2 facts make me suspect Allsup's 96% figure:
1. It's Allsup and their quality is pretty awful as many reps who take over once Allsup withdraws will tell you, as I am sure many ALJs or DDS workers would as well.
2. LTD policies usually award benefits under the "own occupation" standard which is equivalent to the 4th step in the 5-step sequential evaluation process applied in Social Security. The 5th step (again, usually) applies only after LTD benefits are paid for 2 years. So I expect there is at least a group of 4% LTD recipients who would qualify for LTD benefits, but not DIB/SSI benefits. Also, nearly 100% of LTD recipients file for SSA benefits because LTD companies pretty much force them to. Most LTD policies allow the LTD provider to offset LTD benefits by DIB/SSI benefits, and if the LTD recipient declines to file for DIB/SSI, then the LTD policy (usually) allows the LTD company to assume the DIB/SSI benefit amount, and offset LTD benefits immediately.
@1:25 they must be doing something right, they are still in business and still making a lot of money.
@9:14
1:25 here.
I have no idea how much money Allsup is making, and I suspect neither do you.
As to them being "still in business" suggesting quality, not really. If you represent hundreds of thousands of claimants, plenty of those claims are going to be awarded. I'm not saying Allsup is detrimental to the claims, they just don't do a good job adding value to the claim. Assuming Allsup's win rate was similar to the national average rate for unrepresented claimants, given economies of scale I expect Allsup could turn a profit due to their size.
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