Being Told You're A Prisoner When You're Not Sucks

     Can you imagine having the Social Security benefits you depend upon being cut off with no warning on the grounds that you're a prisoner even though you've never been in prison in your life? It happens much more often than you'd think.

     I had a client who was suddenly cut off benefits. When I asked what was going on, I was told that my client was in prison in New Mexico. My client gave a classic response: "I've never been in Mexico in my life!" The New Mexico prison authorities told me that they had no record of any inmate with either the name or Social Security number of my client. It took two months to get the benefits resumed.

Up In The Clouds

     The Social Security Administration is seeking information about using cloud computing in its operations. In general, Social Security has resisted cloud computing since it would disperse computing over many non-agency computers. However, Social Security is now seeking information about an "on-premise private cloud."

Disability Shaming

     I don't think I've ever seen a newspaper article dealing with disability that is as rancid as the one in the New York Post today. The article tells us that Kevin Simpkins is a New York city firefighter. On November 1, Simpkins was driving a fire department van when he was T-boned by another vehicle. Simpkins pulled the driver from her vehicle moments before it was engulfed by flames. The fire department plans to give Simpkins an award for bravery for what he did after the crash. Simpkins tried to go back to work after the accident but lasted only a week before he went out complaining of neck and shoulder injuries. He has filed a claim for disability benefits but it's not clear whether he's seeking temporary or permanent benefits.

     See anything remarkable about Simpkins story? I don't. He was involved in what was obviously a serious car crash. I don't have any problem believing that Simpkins received significant injuries. At this point probably no one, including Simpkins, knows how long it will take him to recover from his injuries or what residuals he may have. His return to work for a week before realizing he couldn't handle it is nothing rare. That sort of thing happens all the time. What's the problem with Simpkins filing a disability claim? 

     Why did the New York Post think it appropriate to try to shame Simpkins for filing a disability claim? They have a few reasons. Simpkins had tested positive for marijuana in the past and was suspended by the fire department for a week. He wasn't supposed to have been driving the van because he had been barred from driving fire department vehicles because of the positive marijuana test. However, there's no allegation that Simpkins was intoxicated at the time of the crash. Otherwise, Simpkins had had a conversation with a neighbor where he suggested that he wasn't all that happy with his fire department job. Also, Simpkins is black and has been involved in a lawsuit against the Fire Department alleging racial discrimination in hiring. That's it. 

     Marijuana may be legal in New York and other states within a few years at the rate things are going. There's no evidence that marijuana had anything to do with this accident. Simpkins wasn't supposed to have been driving that vehicle but that has nothing to do with how seriously he was injured. What difference does it make that Simpkins had some conversation with a neighbor suggesting that he thought he could do better than working at the Fire Department or that Simpkins had filed a discrimination lawsuit? The issue is the severity of Simpkins' injuries. Is the New York Post planning to investigate every city employee who files a disability claim to try to find something derogatory to publish? Will anyone filing a disability claim seem pure enough to the New York Post?

Appropriations Bill Passed

     In case you haven't heard, Social Security now has an appropriation. The agency is funded through September 30, 2014. What I have seen since the beginning of this fiscal year has been rapidly rising backlogs of hearings to be scheduled and Administrative Law Judge (ALJ) decisions to be issued. I hope something can be done to at least stabilize the situation.

Real People Affected By Same Sex Marriage Policies

    A real person being hurt by Social Security outsourcing to the states the decision on recognizing same sex marriages.

Another Field Office Closure

     The Amherst, NY Social Security field office is to close. Local politicians aren't happy.

Exactly Twenty-Five Additions To Compassionate Allowance List

     Social Security has made 25 additions to its "compassionate allowance" list. Why is it that additions to this list always come in round numbers?  Here's the new list:

1. Angiosarcoma
2. Atypical Teratoid/Rhabdoid Tumor
3. Chronic Idiopathic Intestinal Pseudo Obstruction
4. Coffin-Lowry Syndrome
5. Esthesioneuroblastoma
6. Giant Axonal Neuropathy
7. Hoyeaal-Hreidarsson Syndrome
8. Intracranial Hemangiopericytoma
9. Joubert Syndrome
10. Leptomeningeal Carcinomatosis
11. Liposarcoma- metastatic or recurrent
12. Malignant Ectomesenchymoma
13. Malignant Renal Rhabdoid Tumor
14. Marshall-Smith Syndrome
15. Oligodendroglioma Brain Tumor- Grade III
16. Pallister-Killian Syndrome
17. Progressive Bulbar Palsy
18. Prostate Cancer - Hormone Refractory Disease - or with visceral metastases
19. Revesz Syndrome
20. Seckel Syndrome
21. Sjogren-Larsson Syndrome
22. Small Cell Cancer of the Thymus
23. Soft Tissue Sarcoma- with distant metastases or recurrent
24. X-Linked Lymphoproliferative Disease
25. X-Linked Myotubular Myopathy

The New York City Fraud Allegations

     Here is the description of the alleged disability fraud conspiracy  in New York given by Social Security's Inspector General to the House Social Security Subcommittee today:

Upon retiring from the NYPD [New York Police Department] or FDNY [New York Fire Department] (a few of the defendants are other public employees), retirees would contact Esposito or Minerva, who were known within the New York City law enforcement community as men who could assist individuals in obtaining disability or retirement benefits. Esposito and Minerva were the recruiters, and generally instructed the potential applicants that, in order to obtain SSDI, their claim needed to include a psychiatric illness; and that they could create a convincing version of such an illness based on events that occurred while they were working, such as the September 11, 2001 terrorist attacks .

Once they had a new client reeled in, Esposito and Minerva would connect applicants with Hale, a disability consultant who would schedule the applicant with a psychiatrist or psychologist. Since a qualifying disability must be expected to last for a year or more (or result in death), these applicants would generally undergo treatment for a full year before applying. This medical evidence would be included in the applicant’s SSDI [Social Security Disability Insurance] claim, which would be completed and filed by Hale and by Lavallee , who would be the applicant’s attorney of record.

Esposito instructed applicants to exhibit symptoms of depression, anxiety , and related disorders during doctor visits . He coached them on how to act at an SSA consultative examination: how to dress, how to behave, and how to fail a concentration test. Finally, he coached them on specific claims to make, such as that they couldn’t concentrate or sleep, didn’t go out, and even that they were afraid of planes and large buildings, if they were claiming to be disabled based on their participation in the events following the 9/11 terrorist attacks. ...

Because they were treated for a year before even applying for benefits, their ultimate SSDI award included a lump sum retroactive benefit payment from the alleged disability onset date. These lump sum initial payments were between $10,000 and $50,000 . 

The law currently limits a representative's fee to $6,000 of an applicant’s lump - sum retroactive benefit , and with Lavallee listed as the attorney of record, he would generally receive a payment of $6,000 directly from SSA . However, the a greed-upon “fee” paid to the facilitators by these fraudulent beneficiaries was generally 14 months’ worth of benefits, as much as $45,000. 

To make these payoffs, Esposito instructed applicants to withdraw cash from their banks in small amounts so as not to trigger IRS reporting requirements or any suspicions on the part of their financial institutions. The applicants would then make cash deliveries to Esposito and/or Minerva of an amount equal to 14 months’ worth of benefits, less the $6,000 Lavallee had already received from SSA . Esposito and Minerva would then split the cash with their co-conspirators.

      Maybe it all went down exactly like this but it sounds bizarre to me. A few questions:

• Why were there all these middlemen?
• Why undergo a year of psychiatric treatment before filing the claim? You don't have to do that. The standard advice from reputable Social Security attorneys for claimants with psychiatric problems who are not in treatment is to file the claim now and get in treatment now. Don't delay doing either one.
• Here's the big question: I have a hard enough time persuading clients who unquestionably have psychiatric problems (and these include people with a history of multiple involuntary commitments due to mental illness) to get in treatment and stay in treatment yet the allegation here is that people who did not have psychiatric problems voluntarily submitted to seeing a psychiatrist over the course of a full year and repeatedly making false assertions to the psychiatrist. Would you do that?
• Why would these allegedly fraudulent claimants voluntarily pay vastly inflated attorney fees?