Put halt to bogus disability claims

[Guest guest]

Put halt to bogus disability claims

http://www.tampabay.com/opinion/editorials/article443705.ece

Ortiz, a 27-year-old gas station clerk in San Diego, was hurt

in a car crash. Simmond, a 41-year-old restaurant manager in

Atlanta, hurt her wrist rolling out pizza dough. But their stories

have two things in common, according to an article published Tuesday

in the New York Times: Both expected to recover and return to work,

yet both were pressured by their insurance carrier to hit up the

government for disability benefits. Critics say bogus claims have

cost Social Security millions of dollars and slowed the processing of

disability applications to a crawl.

The disability system exists to give basic living assistance to

working-age people too severely injured to return to work. The

assistance fills an important gap for people struggling with no

income and who face medical or other debts and are years away from

normal retirement. According to the Social Security Administration, a

20-year-old worker has nearly a one in three chance of becoming

disabled before reaching the retirement age. That is a huge

population to serve, especially as our work force ages. The nation

certainly cannot afford insurers fobbing off their customers on the

government.

But that is happening. According to whistle-blower lawsuits cited by

the New York Times, insurers are forcing their claimants to also

apply for Social Security disability assistance — whether they

qualify or not. Social Security has stringent qualifications for

disability pay, at least on first application. The lawsuits allege

that insurers have forced their claimants to apply, and to appeal if

their claims are denied. This buys insurers time and could reduce

their payouts by shifting costs to Social Security, which is

projected to run out of money in 2026. A spokesman for the agency

said research shows that one in five of the 2.5-million applicants

each year acknowledge they are unqualified.

This is an abuse of both injured workers and the Social Security

system. The former administrator of the disability program,

Nibali, who is serving as an expert witness for the plaintiffs, said

the bogus cases are holding up the applications of people who have

been waiting years and who often " are much worse off. " The number of

people waiting to make their case to an administrative law judge has

doubled since 2000, as has the average wait time, to 512 days.

Plaintiffs' numbers indicate the insurers have sent thousands of

suspect cases to the agency, costing the system hundreds of millions

of dollars over the last decade, the newspaper reported. The

government needs to clamp down on this abuse by making eligibility

crystal clear and by punishing insurers who force their customers to

play games. Injured workers deserve ready access to disability

benefits. And disability insurers need to meet their obligations to

the nation's work force.