AURORA, N.Y., Sept. 30, 2013 /PRNewswire/ — Fraudulent claims are a significant drag on the nation's $128 billion Social Security Disability Insurance (SSDI) system. In response, private investigators are stepping up their work to catch cheaters in the act, saving money for insurance providers and employers.
The numbers paint a clear picture. Over the last 20-plus years, as welfare reforms have pushed people out of that system, the number of people receiving disability insurance has skyrocketed. In 2012, nearly nine million people were receiving monthly SSDI checks. The trend of more applicants entering than leaving the system shows no sign of slowing.
Ryan Stromik, president of Marley Investigative Consultants, LLC in South Florida, cautions that because most claims are in fact legitimate, investigators must exercise prudence when researching any individual claimant and not make any hasty conclusions. But fraud does persist, and this fraud is difficult to quantify. A Senate investigation showed that one in four claims decisions had serious flaws—not that each of these cases was outright fraud, but certainly many were. In a sputtering economy, moreover, the incentive to draw an SSDI check could be greater than simply being unemployed or stuck in a low-wage job.
Along with an increase in raw numbers, the character of disability claims has been changing as well. Verifiable accidents and injuries (amputations, head injuries, etc.) have held relatively steady, while more nebulous claims have been on the rise. In particular, claims based on mental disorders and back pain together make up more than half of all disability claims, according to a Social Security Administration report from 2011. It's perhaps no coincidence that back pain and mood disorders are difficult to prove, and therefore difficult to disprove.
For corporations and insurance providers, investigation of disability claims is a matter of simple economics. Uncovering a fraudulent claim early, perhaps even during the vetting process, can save tens of thousands of dollars. It's not about a lack of trust in particular workers, but rather a matter of preserving the bottom line. By most estimates, improper disability payments may exceed $20 billion each year. Some of that impropriety may be honest mistakes, but much of it is deliberate cheating. Private investigators are experts at knowing the difference.
Private investigators employ a range of techniques when seeking to uncover disability fraud. These include, but are not limited to:
- Surveillance: Investigative surveillance includes both audio and video. The idea is to record the claimant doing something that they are allegedly unable to do, per doctor's orders.
- Research and Interviews: Neighbors, colleagues, friends and family are valuable sources of information during a fraud investigation.
- Background Checks: An unusual history of workers' compensation or disability claims may indicate that a person is attempting to game the system.
- Financial Evidence: The claimant, his attorney, his doctor and perhaps even the presiding judge may all be part of a network benefiting from SSDI fraud. Private investigators can probe financial records to discover any suspicious fund transfers.
Stromik adds, "There is no such thing as a typical case. I try to think outside of the box and deliver as much information to my client as possible. The ultimate goal, of course, is to gather enough information, through a variety of techniques, to draw some conclusions about the person in question."
Niche marketing firm PI Profits Agency (http://piprofitsagency.com/) recommends specialization as one method for improving a PI firm's bottom line. That said, the steady rise of SSDI claims will have investigators quite busy for the foreseeable future, making this a growth sector for any PI firm.
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