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What is a Cooperative Disability Investigation?

Posted October 29, 2021 by Premier Disability Services, LLC®

You may have heard that the Social Security Administration will investigate you if you are applying for or receiving Social Security disability benefits. While it is unlikely that Social Security will hire a private investigator or search through your online and social media presence, this could very well happen if a red flag has been raised as to the validity of your claim. Maybe someone filed a complaint or your treating medical professionals have raised some suspicions about your disability. If so, you could be referred for what is called a “cooperative disability investigation,” or CDI.

CDI is a joint initiative involving the Social Security Administration (SSA), the Office of the Inspector General (OIG), state Disability Determination Services (DDS), and various State and local law enforcement agencies. The primary goal of a CDI is to uncover potential cases of Social Security Disability claim fraud.

The process typically begins with a referral from the DDS or SSA to the CDI Unit. Fraud referrals also come from SSA’s Office of Hearings Operations, private citizens, anonymous sources, and other law enforcement agencies. Cases of Social Security Disability fraud can involve malingering (exaggeration or faking illness to avoid work), filing multiple applications, concealing work or other activities, and otherwise exaggerating or lying about disabilities.

The CDI Unit Team Leader screens the referral. If it accepts the case, the Team Leader will work with the state or local law enforcement members of the team to investigate the allegation by interviewing the applicant and third parties and/or conducting surveillance of the applicant. Sometimes the investigators will speak to the applicant undercover, maybe under the guise of a person asking for directions, to see how the applicant interacts with strangers when they do not suspect they are being evaluated. Other times, the investigator may simply follow the applicant and watch them from a distance to observe their movements and activities.

Social media can also be a valuable resource for these kinds of investigations. While Social Security may approach social media data with trepidation, as posts can often be a poor reflection of the reality of a person’s situation, it can still be used to see if you are acting in ways that are counterintuitive to a person with the disabling condition you are claiming for benefits purposes.

Upon completion of the investigation, a report is sent to DDS, where DDS staff serves as the ultimate decision-making entity in determining whether a person is eligible to receive a monthly disability benefit payment. Or, if the claim is brought in front of an administrative law judge for a disability hearing, the judge will review the CDI report as part of the evidence in the case. If the individual being investigated is already receiving benefits, DDS and/or SSA will determine whether their benefits should be continued or terminated. In some cases, there is a possibility of criminal prosecution or the imposition of civil monetary penalties or administrative sanctions.

A CDI is not necessarily hurtful to your claim as long as you were honest in filling out your Social Security paperwork and testifying at your hearing. However, it is important to be mindful of the information you share on the internet and social media, as well as when you are talking to others, such as your doctor. Remember that any statements you make, or activities you engage in, may become evidence in your disability claim.

Contact our office today if you or anyone you know would like to learn more about qualifying for Social Security Disability benefits.

By: Devon Brady of Premier Disability Services, LLC®

It’s Open Enrollment for Medicare!

Posted October 22, 2021 by Premier Disability Services, LLC®

Each year, you have a chance to make changes to your Medicare Advantage or Medicare prescription drug coverage for the following year. The open enrollment period for Medicare for 2022 coverage began on October 15, 2021 and will continue through December 7, 2021.

During this annual enrollment period you can make changes to various aspects of your coverage.

  • You can switch from Original Medicare to Medicare Advantage, or vice versa.
  • You can also switch from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another.
  • And if you didn’t enroll in a Medicare Part D plan when you were first eligible, you can do so during the general open enrollment, although a late enrollment penalty may apply.

If you want to enroll in a Medicare Advantage plan, you must meet some basic criteria.

  • You must be enrolled in Medicare Part A and B.
  • You must live in the plan’s service area.
  • You cannot have End-Stage Renal Disease (some exceptions apply).

There are specific times when you can sign up for these plans, or make changes to coverage you already have. You don’t need to sign up for Medicare each year. However, each year you’ll have a chance to review your coverage and change plans.

If you didn’t sign up for Medicare A and B when you were first eligible, you have a chance to do so each year from January 1 to March 31, with coverage effective July 1.  You may be subject to a late enrollment penalty however.  For Medicare Part B, the penalty is an additional 10 percent of the premium for each 12-month period that you were eligible but not enrolled.

If you have questions about Medicare, please feel free to give us a call! Our team of Medicare specialists may be able to assist you.

Read more here: https://www.cms.gov/Outreach-and-Education/Reach-Out/Find-tools-to-help-you-help-others/Medicare-Open-Enrollment.html

Plan finder: https://www.medicare.gov/find-a-plan/questions/home.aspx 

Contact our office today if you or anyone you know would like to learn more about qualifying for Social Security Disability benefits.

By: Tom Klint of Premier Disability Services, LLC®

Social Security Announces its 2022 Cost-of-Living Adjustment

Posted October 15, 2021 by Premier Disability Services, LLC®

The Social Security Administration has announced its cost-of-living adjustment (COLA) for 2022. Each year, federal benefit rates increase when the cost of living rises, as measured by the Department of Labor’s Consumer Price Index (CPI-W). 

The CPI-W rises when inflation increases, making your cost of living go up. This means prices for goods and services, on average, are a little more expensive, so the COLA helps to offset these costs.

The Administration has announced that Social Security and Supplemental Security Income (SSI) benefits for approximately 70 million Americans will increase 5.9 percent in 2022. This is the largest increase since 1982 (in 2009, benefits were increased by 5.8 percent).

The estimated average monthly benefits payable to all disabled workers will rise to $1,358. The maximum SSI monthly benefit will rise to $841 for an individual, or $1,261 for a couple.

The 5.9 percent COLA will begin with benefits payable to more than 64 million Social Security beneficiaries in January 2022. Increased payments to approximately 8 million SSI beneficiaries will begin on December 30, 2021.

January 2022 marks other changes based on the increase in the national average wage index. For example, the maximum amount of earnings subject to Social Security payroll tax, as well as the retirement earnings test exempt amount, will change in 2022. The monthly substantial gainful activity (SGA) amount will be $1,350 for a non-blind individual and $2,260 for a blind individual. The monthly earnings threshold for a trial work period (for those already receiving benefits) will change to $970.

Read more about the 2022 COLA here.

Contact our office today if you or anyone you know would like to learn more about qualifying for Social Security Disability benefits.

By: Joyce Trudeau of Premier Disability Services, LLC®