Tag Archives: disability fraud

SSDI: Half Would Be Outraged, Half Would Apply For Benefits

The headlines are everywhere: the SSDI (Social Security Disability Insurance) fund is set to run out in late 2016 if something isn’t done to replenish it.  It’s not that most people don’t see the need for it, but with the fraud, waste and abuse that plagues the Social Security system, people don’t want it to be reauthorized without some reforms put into place to help curb the fraud, waste and abuse.  According to THIS NBC News article, changes made in 1995 opened the door to get benefits for certain disorders.  The number of “Musculoskeletal conditions and mental health disorders” claims has exploded. What happens when a backlog happens in a system where performance is judged by quantity instead of quality?

Corners are cut.

And what typically can be found in places where corners are cut?

Fraud, lies, greed, and theft.

When you first make a disability claim, you can expect that it will likely get denied.  There’s no shortage of internet sites that tell you this and all about the process.  A Residual Functional Capacity (RFC) is compiled with input from the Disability Determination Services (DDS) agency and information documented from your doctor.  The goal for someone who really doesn’t want to work apparently is to get an RFC that says you aren’t even capable of doing “sedentary work”. What is that?  It means you can’t lift more than 10 pounds at a time, mostly sit with occasionally walking and standing. The disability examiner determines, given your skills, age and abilities, if you can be taught another job.  If you are making a claim for physical disabilities, it’s completed by a physician.  If it’s for mental ones, a psychologist or psychiatrist will reference your mental symptoms that affect your ability to work. Site after site recommends you have an attorney to help you navigate through the denials you are likely to get.  And when you do, here’s what they won’t tell you, but should: if you aren’t supposed to be working, then DON’T.  Also, if you’re caught pretending, faking or malingering, you can go to prison.

Attorneys know, hear about, or learn which judges tend to do what.  You can even find the claim approval statistics BY JUDGE for the Administrative Law Judges on the internet! HERE it is for Maryland. The danger comes when an attorney, more focused on winning at all costs for his/her client, helps the client to bend and fudge the facts instead of protecting the very system they may one-day need from abuse.

A report was released by the Committee on Oversight and Government Reform, available by clicking HERE, that is sub-titled “How Rubber-Stamping Disability Judges Cost Hundreds of Billions of Taxpayer Dollars”.  As a result of the rampant fraud and abuse of the SSA benefits system, investigations are on the rise.  And when a person, determined to lie to get benefits, hires a lawyer who colludes with your lies, the clock starts ticking.  See THIS story about the scheme by Judge David B. Daugherty and attorney Eric Conn (appropriate last name) to defraud the SSDI system by fast-tracking claims through the administrative hearing process for people who very likely didn’t deserve benefits at all.  How do you get the medical data to support it?  Easy!  Use doctors recommended by your lawyer who “you could get them to do what you want”.

I found and watched the 60 Minutes story on the disability fraud, and you can too by clicking HERE. The Vice President of the Association of Administrative Law Judges, Marilyn Zahm, said “if the American public knew what was going on in our system, half would be outraged and the other half would apply for benefits.”  I know which half I am, and I know a few people who have shamelessly and shamefully applied for benefits.  Read the comments on the video site.  Others apparently know of them too.

Malingering for Federal and State Benefits

Thanks to everyone who commented on the last blog post concerning surveillance and disability fraud investigations. Due to the comments we posted (and those we didn’t), we are writing this post about the concept of Malingering. What is it, and why would someone do it?

According to Medscape, malingering in the DSM-V is described as “”The essential feature of Malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives such as avoiding military duty, avoiding work, obtaining financial compensation, evading criminal prosecution, or obtaining drugs.” That’s a mouthful! Let’s look at a few cases involving the financial compensation part.

Larry Benson’s Fraud of the Day site recently wrote about a guy who was “mooching” by claiming to have an injury that didn’t prevent him from playing basketball and working out at the gym (good old surveillance at work). That guy got almost 9 years time for his fraud.

The military handles malingering under Article 115. You can find it by clicking HERE. It is a punishable offense. THIS retired Air Force captain suggests that the VA could possibly have fewer cases of malingering on their hands if they got corroboration from civilians who know what is really going on with the people they live and interact with (a form of surveillance and intel). Another story of a guy malingering and lying about injuries to obtain benefits (and being reported by others) can be found HERE. He faces a maximum of 15 years and a $250,000 fine.

It’s not just limited to physical injuries, unfortunately. The numbers of people getting diagnosed with PTSD has swelled through the past several years. And so have the numbers of people that actually have “Pseudo-PTSD”. Without a doubt, true sufferers of PTSD deserve all of the help, medical and financial, that our Country can give to them. Their symptoms also are COMPLEX. People who actually have Pseudo-PTSD, and are malingerers, take away the ability to do justice to the true sufferers. Many articles can be found on this but journal articles are respected more and one can be read by clicking HERE . A fantastic writeup done by an attorney on how to combat someone’s claim of PTSD (which includes surveillance and digging into the past of the claimant) can be found HERE.

Perhaps the Veteran’s Benefit Administration AND the Social Security Administration could financially benefit from using some of these resources in order to combat such fraud. Perhaps they already are!  Your Country thanks you for your help in detecting it.

NOTE: it’s been one year since this blog started. We almost made it to 75,000 page hits! Many thanks for spreading the word, and we look forward to doubling the numbers in year 2. There is a lot left still to write about.

Using Surveillance to Catch Disability Fraud

Fraudulent claims for disability have been a problem for the Social Security Administration for years.  The ways that fraud investigators find the fraudster range from simply putting two and two together with documents, to relying on anonymous tips via their fraud hotline. In between, investigators often root out the fraudster from simply watching them.  It happens more and more these days.

THIS guy was receiving more than $6000 per month for his “disability”, but meanwhile was seen playing basketball, doing yardwork, and washing his boat that the author says was probably purchased using his disability payments.  He was getting money from SSA and Veteran’s Affairs.

THIS woman was caught committing worker’s comp fraud by using video surveillance.  One minute, she needed a cane and a brace, and the next she could function just fine without it.

The Social Security Administration has a Cooperative Disability Investigations Program that routinely employs the use of video surveillance in order to catch fraudsters.  A few of their cases can be read about by clicking HERE.  More can be found on video surveillance by clicking HERE.  An attorney did a nice writeup about the ways that surveillance is conducted.  It includes interviewing 3rd parties and reviewing information found on social media.

THIS story reports on the retired officers and firefighters who were charged with making fraudulent PTSD claims for disability to the Social Security Administration.  There were more than 100 of them. On their paperwork, apparently they kept writing that “I’m unable to perform any type of work activity in or out of the house”.  But they were found to be jet skiing, piloting planes and doing work.  If you write that you can’t do things, than don’t be seen or heard doing those things.  Period.

You should especially not be out in very public venues doing any of the things that you attested to not being able to do.  Being on The Price is Right, grabbing the big wheel when you are getting disability pay for a shoulder injury, is a no-no. Going zip-lining while on vacation with your partner, is another.  I’d like to know how they found out what Cathy Cashwell was doing while on vacation! (ooh, it’s probably by first checking bank and credit card statements and getting it confirmed from pictures!) It’s called malingering (faking an illness for personal gain).  The Form 3368 for a malingerer, makes for interesting and entertaining reading indeed!  A note to fraudsters: if the doctor you listed in Section 8 is someone who is known to certify for bogus claims, you may want to turn yourself in before you are caught. And shame on you for listing and wasting good meds that could be used for someone who really intends to take them.

How can you get away with disability fraud?  Here’s advice from the investigator written about in the story above: ““The best way and only way of beating the system is completely staying in your house, not leaving for three to five years.” Cathy, I bet you don’t have that smile you had on the Price is Right video now!

We Would All Hide Assets And Ride Off Into the Sunset of Retirement

That’s what the U.S. Attorney said to the jury for the trial in Federal court of a woman charged with committing Social Security and Bankruptcy fraud. What follows is a writeup of a woman who was caught doing the very things that I’ve seen happen in a bankruptcy case that I am involved in. I have been wondering what the possible penalties are for people who actually get caught and charged, and the story of Sheryl Bruner provides some guidance.

Poor Bruner. An upstanding woman who was receiving disability pay and trying to be a good citizen, but whom was overwhelmed with her bills and debts. She filed for bankruptcy protection to try to get that “Fresh Start” that all Americans are entitled to seek. Only, Bruner wasn’t the poor soul that she painted herself to be in her bankruptcy petition.

I’ll let you read the linked story found on Fraud of the Day’s website, found HERE, to read Larry’s take on the story. She was running companies, lying on her Social Security recertification statements about her activities, and concealing assets such as a TD Ameritrade account; a stash of money in her house; bank accounts not on schedules, assets not disclosed, etc. Ah, so people DO get charged with bankruptcy fraud for doing those things! When I read about her car, paid for in cash, I almost thought I was experiencing dejavu! When I read that she thought she didn’t have to disclose things about her assets and activities that were involved with her LLC, I knew it was dejavu.

Gotta love when someone tries to throw their attorney under the bus by saying that they did something or filed something that they weren’t aware of (which is malpractice). Gotta love even more the prosecuting attorney who plays an audio tape of the debtor’s statement in their meeting of creditors that confirms what all debtors are asked: did you see, read and sign your petition? YES, she did. And no Sheryl, it doesn’t work to try to allege that your lawyers were shady if you didn’t complain to what is known here in Maryland as the Attorney Grievance Commission. Her lawyer, who tried to “defend” his client by essentially defaming her bankruptcy counsel, said that he was doing so because of his obligation to his client. The U.S. District Judge that heard the case was not convinced, reporting that she was going to investigate the matter and hold the defense attorney accountable for his actions.

Apparently, Ms. Bruner thought she could try to hide behind the fabricated actions of someone else in order to try to cast doubt regarding what were HER fraudulent actions. Pay attention: it is the debtor’s responsibility to ensure that the information contained on the bankruptcy petition is correct prior to the attorney uploading it to the Federal docket. The attorney only knows what their client tells them, which is why they are supposed to get the statements from the client that shows the truth. If a client decides to withhold info from their lawyer, then it is the CLIENT who is committing fraud. Doesn’t matter if you amend your schedules later to add things because you found out that questions were being asked. That’s called Trying to Feign Compliance After Your Crime. The jury didn’t buy it, and it took about two hours for them to convict her. You can read HERE for another perspective about this story.

The U.S. Attorney said that the woman “never misses an opportunity to game the system”. Unfortunate that she had to put her retirement and freedom at risk by being so greedy. More unfortunate that she, like others, think they can continue to use that same system to try to get them out of the trouble resulting from that gaming/fraud. Larry wrote “Compulsive lying got this fraudster into a heap of trouble that will most certainly give her plenty of time behind bars to work on breaking her bad habit.” In my experience with someone with similar tendencies, some habits can’t be broken. Especially if the person has no remorse, and believes that they only thing “wrong” is that they got caught.

For those that asked for information regarding the fraud charges Bruner faced, here is the indictment:

Download (PDF, 298KB)

And here is more about her seized money, and what she tried to do with it:

Download (PDF, 223KB)

 

You can find more about her various filings in her defense of the charges by doing an internet search. You will see them all.

It is STILL the case that…

We can all help one another stop bankruptcy fraud

Disability Fraud Of Maryland Vets Exposed

In this post, we are going to talk about a case of VA benefits fraud and illegal tax breaks in Maryland. The backdrop for this is the story that broke a few months ago concerning six veterans who were found to be receiving “agent orange” benefits as well as MD state tax waivers fraudulently. Apparently, the Deputy Chief of Claims at the Maryland Department of Veterans Affairs, David Clark, was helping vets to get these illegal benefits by falsifying their records and amending them to back up claims. He was receiving a cut of the illegally obtained money as payment for services rendered. Apparently, since Mr. Clark knew what was needed in order that the claims would sail through, his position of authority made it easier for the fraud to go undetected until now.

The story that we’ve attached also references the use of “using counterfeit DOD forms to change service.. records.”, and another story about Clark referenced below indicates that he also submitted false doctor’s letters regarding illnesses. Apparently, Mr. Clark also changed paperwork to place medical diagnoses on them that didn’t actually exist.

The story also references the claim that there are too many claims being processed “..to be able to double-check the accuracy of information..” submitted on them. It is also noted that “outdated systems make it more difficult to catch schemes and people.” It looks to us to be yet another case of people and agencies relying on the moral integrity and honesty of the people giving information.

We think that they should check the Maryland disability claims that were processed in Maryland after the date that Mr. Clark submitted one fraudulently for himself: 2001.

On another blog site that we found that is also chatting about this story, there are people who have commented about things such as:

Being able to “forge a DD-214”

“There is no doubt that a DD-214 and other discharge paperwork, even orders could be forged.”

“I would not be surprised if 10% or more of the VA’s budget goes to pay for compensation, medical care, etc . . . , that’s based on fraudulent claims.”

“They don’t seem to cross-check this against official records at NPRC and/or the services.”

“To be fair, virtually ANY document, paper or electronic, can be forged if the forger is determined enough.”

That site can be found HERE

One of the best suggestions made by someone on that site, is that the Vet should be asked to “..fill out and sign a SF180 giving you access to his records.” In the case of medical records while in the military, you would need the vet’s written permission to access them. You won’t need their written permission in order to get their exit/discharge order. You will clearly be able to see on it, if they were really discharged for medical reasons as they are claiming, or perhaps just “retired”. This would go a long way to catch those who are attempting to commit fraud for personal financial gain.

It would appear that one of our site’s question of “Can a person claim a disability that doesn’t exist, and get paid for it?” has been answered in the affirmative. Stay tuned. We will report the other stories that are bound to surface related to issues such as this. Keep going, US Attorney Rod Rosenstein!!

The Baltimore Sun story is below:

Download (PDF, 46KB)

The other Sun story is linked HERE