Lessons From NY Disability Fraud Case

Another round of disability fraud in New York City has made national headlines and it’s an excellent example of how disability claims can be abused. There were already 100 retired firefighters, police officers, jail guards and others accused of scamming the Social Security disability system and most recently 32 more people were charged.

An interesting aspect of this round of allegations is that some of the newly accused happen to be the sons of some of the men from the first round of accusations. These fathers are thought to be the ringleaders of this whole operation. The early numbers of the amount of the people and money from this scam were revised and now prosecutors believe there could be hundreds of people involved in cheating the Social Security disability system out of $400 million.

One of the key points of this scheme is that half of those accused are charged with faking the symptoms of post-traumatic stress disorder to get a payday from the Social Security disability benefits program. A lot of the recipients were told to link their conditions to 9/11.

The fathers who are a part of the accused include a retired police officer and a benefits consultant, they are a part of a group of four men that are thought to be involved in telling the disability retirees how to get away with faking their conditions. It is also alleged that these four men received tens of thousands of dollars in secret payments, all four of these supposed ringleaders deny the charges.

We don’t yet know if any of the accused are guilty because they have not yet gone to trial. While all of the accused will have their day in court, this second round of Social Security disability fraud accusations demonstrates why it is important to have a quality Independent Medical Examination (IME) at the beginning of any claim for Disability benefits. A quality IME means there will be less of a chance that a claimant will be able to fake their disability.

According to CNN “Prosecutors said the defendants were meticulously instructed on how to fail memory tests with plausibility, how to dress and how to behave. Nearly every application included identical descriptions of daily living.”

There will always be people who will try to lie to receive a check from disability benefits program, it doesn’t matter if it is private sector disability insurance or the Social Security disability system. Disability insurance is an important benefit for millions of Americans and the only way to protect the reliability of these systems is to make sure that the providers who examine the claimants are using the most rigorous standards.

There are ways to determine if a claimant is trying to fake a disability claim, this is true if it’s a physical or psychological disability claim. The best and most experienced providers use multiple testing methods to bring out a false claim. There are tests where the same questions are asked in different ways to see if someone is falsifying information.

Some providers who do IMEs for disability claims may have a large amount of claims that they need to do exams for, again this can be true for private sector disability or the Social Security. While each of these exams can be a daunting task, it’s important to know that your providers will pay attention to details with each IME they complete. The urge to rush through an IME must be resisted. The integrity of the private and public disability insurance systems depends on it.

The big lesson to take away from the NY Disability Fraud Case is this: it’s all about the providers. Disability insurance claims depend on providers knowing how to provide an unbiased and thorough IME. This will help to prevent fraud and make sure that disability insurance works for the people who really need it.