At the Sullivan Law Office, we interview a large number of prospective disability clients every week. While many of them are anxious to discuss their reasons for believing they are entitled to benefits, our lawyers also like to focus on any relevant personal facts that may provide reasons or grounds for the denial of benefits. At times, these reasons may be within the control of the applicant and therefore avoided to prevent any denial of benefits. This is one of the main reasons why the representation of an experienced disability attorney is vital to the initial application process. This is the fourth and last part of a blog on reasons why the SSA denies an applicant Social Security benefits.
If the SSA discovers that an applicant obtained disability benefits by acting fraudulently or dishonestly, it may terminate benefits and in some cases, pursue criminal charges for fraud. We have all heard of the case of attorney Eric Conn case. Mr. Conn has been indicted on fraud. He had the same doctor see many of his disability clients. The SSA had to rehear over 1000 cases based on fraudulent medical proof. This is rare, but still a fraud matter.
A more common source of fraud is working and drawing disability. It is technically possible to draw disability and work (usually part time). The regulations are complex and you need to consult an attorney, and you always need to report your work activity and associated earnings. The fraud cases based on work activity are typically pretty extreme. Usually they revolve around people working full time, not reporting (or flat out lying about their work), and drawing disability. There is a recent Sixth Circuit case wherein someone drawing disability also worked full time for a municipality. He had relatives in government and had the checks issued in his son’s name. It took years but the SSA discovered it and the players were all criminally charged. Oddly, there was also an identity theft issue.
Conviction of a Crime
Applicant’s disabling conditions which are the result of, or worsened by, committing and conviction of a felony, are not eligible for benefits. As an example of this rule in play, think of a high speed police chase. The fleeing criminal loses control of his stolen car wraps the vehicle car around a tree. He shatters both legs. He is charged and convicted of several felonies, one of which is fleeing. The injuries from that crash cannot be a basis for an award of disability. This is a cruel regulation, but I have seen it play out and bar benefits.
In many cases, if possible, a suspect may plead out to a misdemeanor to avoid the felony conviction, in which case the rule may not bar the disability claim. Creative lawyering can also potentially flank the rule. I have seen cases where the originally injury was not a basis for an award, yet post-op infections and their residuals become a basis for an award. So even if the criminal was convicted of a felony and needed major orthopedic surgery, if something goes wrong during or after the surgery (such as an infection), an argument can be made that the person is still disabled under the law. As you can expect, these cases do not draw much sympathy and are challenging.
However, it may still be advantageous to apply for SSDI benefits because even if cash benefits are unavailable, the SSA may still grant a period of benefit-free disability that will suspend a prospective applicant’s earnings record, keeping eventual disability benefits level and preventing them from decreasing. Also, the criminal case may take a very long time.
One of the best ways to improve your chances of avoiding the denial of benefits is by retaining the services of a qualified Kentucky Social Security Disability attorney. Working with an attorney that is experienced in Kentucky Social Security Disability cases ensures that you have the best chance of successfully filing a disability application. If you have any questions or concerns about any kind of disability cases, including Social Security Disability, long-term disability, short-term disability, state retirement and workers’ compensation, call the Sullivan Law Office today! Call 888-587-0228 or visit us online. We have forty years of experience!