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Senate Panel Uncovers Millions in Disability Fraud

October 23, 2013

Story at-a-glance

  • The Federal Disability Insurance Program has a $135-billion budget and serves close to 12 million people, but its funds are in danger of running out
  • The Senate Subcommittee for Investigations believes the program is being abused – by lawyers, doctors and even some recipients – putting the benefits for those who truly need them at serious risk
  • According to the Senate investigation, up to 25 percent of disability files should not have been approved and another 20 percent are highly questionable
  • Some Americans are using disability benefits as a financial bridge after their unemployment benefits run out; it’s easy to do since so many Americans have chronic conditions or impairments
  • As a whole, Americans are not healthy – they're tired, depressed, stressed out and often in pain – taking control of your health can help you to avoid disability and heal your body naturally

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By Dr. Mercola

The Federal Disability Insurance Program was started in the 1950s to assist people who were unable to work due to injury or disability. Today, the program has a $135-billion budget and serves close to 12 million people, but its funds are in danger of running out.

With a 20 percent increase in the last six years alone, the Federal Disability program now spends more in an average year than the Department of Homeland Security, the Justice Department, and the Labor Department combined, according to a 60 Minutes segment by CBS News.1

For those who need it, the Disability Program is invaluable, but the Senate Subcommittee for Investigations believes the program is being abused – by lawyers, doctors and even some recipients – putting the benefits for those who truly need them at serious risk.

Disability: A System Ravaged by Waste and Fraud?

If you watch TV, you've probably seen commercials for disability lawyers advertising their services, hoping to earn a dollar and a cent by appealing cases from the two-thirds of people who applied for disability and got rejected. Last year alone, the Social Security Administration paid $1 billion to claimants' lawyers.2

Certainly, some of these lawyers are providing an honest service, but others clearly appear to be exploiting the system. CBS News used the example of one attorney who runs the third largest disability practice in the US.

The Senate investigation revealed that he had collected more than $13 million in legal fees from the government over six years, while paying five doctors about $2 million to "sign off on bogus medical forms that had been manufactured and filled out ahead of time by… [his] staff."3

According to the Senate investigation, up to 25 percent of disability files should not have been approved:4

"The Social Security Administration, which runs the disability program says the explosive surge is due to aging baby boomers and the lingering effects of a bad economy. But Sen. Tom Coburn of Oklahoma, the ranking Republican on the Senate Subcommittee for Investigations -- who's also a physician -- says it's more complicated than that.

Last year, his staff randomly selected hundreds of disability files and found that 25 percent of them should never have been approved -- another 20 percent, he said, were highly questionable."

Many Over 40 'Have Some Sort of An Ailment or Impairment'

In many cases, experts say, some Americans are using disability benefits as a financial bridge after their unemployment benefits run out. Faced with a still slow economy and limited or nonexistent job prospects, some become desperate and turn to the government for help.

Meanwhile, since so many have chronic conditions, from chronic pain and fibromyalgia to depression and anxiety, it becomes a fine line of who to help and who to turn away…

Marilyn Zahm, US disability judge and president of the Association of Administrative Law Judge, told 60 Minutes:

"People run out of unemployment insurance. They are not going to die silently. They are going to look for another source of income. It is not unusual for people, especially people over 40, to have some sort of an ailment or impairment. So they will file for disability benefits based upon that. For many of these people, the plant closed. There are no jobs in their communities. What are people supposed to do?"

Is there waste going on in the US Disability Program? Certainly. Is there fraud? Yes. Still, those who do receive it are not getting rich off their payments, as CBS News pointed out. Payments typically amount to minimum wage income of about $1,100 a month, plus Medicare benefits after two years.

Yet in big-picture terms, each new case costs taxpayers about $300,000 in lifetime benefits… a number that is quickly becoming unsustainable. Ultimately, this is just one more instance where the health care system, or rather, the disease care system, is failing Americans.

What Are the Leading Causes of Disability?

Arthritis, back problems and heart trouble make up the top three causes of disability among US adults.5 These are also three conditions for which the conventional US health care system offers little by way of prevention and treatment, other than offering prescription drugs and, perhaps, surgery.

Many become even more debilitated when they seek care from their conventional doctors, suffering prescription drug side effects or medical errors that can permanently disable or even kill.

Authored in two parts by primary author, Carolyn Dean, MD ND, the comprehensive "Death by Medicine" article described in excruciating detail how everything from medical errors to adverse drug reactions to unnecessary procedures cause more harm than good. That was in 2003. In 2010, an analysis in the New England Journal of Medicine found that, despite efforts to improve patient safety in the past few years, the health care system hasn't changed much at all.6 Researchers noted:

"In a study of 10 North Carolina hospitals, we found that harms remain common, with little evidence of widespread improvement."

They revealed that 18 percent of patients were harmed by medical care (some repeatedly) and over 63 percent of the injuries could have been prevented. In nearly 2.5 percent of these cases, the problems caused or contributed to a person's death. In another 3 percent, patients suffered from permanent injury, while over 8 percent experienced life-threatening issues.

What's Your Lifestyle Got to Do With It?

Remember, pharmaceutical side effects and medical mistakes are major contributing factors to Americans' disabilities. So, too, are poor lifestyle choices to begin with, which add fuel to the fire, encouraging the development of diseases that are then 'treated' inappropriately, often causing more harm than good. Consider these facts from the Council for Disability Awareness:7

  • "Illnesses like cancer, heart attack or diabetes cause the majority of long-term disabilities. Back pain, injuries, and arthritis are also significant causes.
  • Lifestyle choices and personal behavior that lead to obesity are becoming major contributing factors.
  • Musculoskeletal disorders are the #1 cause of disabilities. Examples include; arthritis, back pain, spine/joint disorders, fibromyalgia, etc."

No one wants to feel lousy, fatigued and in pain. And such conditions undoubtedly make it difficult, if not impossible, to make a living. In many cases (not all, but I'd venture to say most), changing your lifestyle can dramatically change the way you feel, improving or even eliminating a disability like back pain, arthritis pain, obesity, type 2 diabetes and many others.

The US Health Care System Is Another Area of Extreme Waste and Fraud

In some ways it seems misdirected to be investigating a program with a $135-billion yearly budget while the US health care system, which has annual spending of $2.7 trillion, goes largely unchecked. Americans spend more on health care than citizens of any other country, up to 1.5 times more per person, yet we rank 50th in life expectancy and 47th in infant mortality. These are absolutely dismal outcomes from the most expensive health care system in the world!

Further, according to a survey of US health care expenses by the Institutes of Medicine,8 30 cents of every dollar spent on medical care is wasted, adding up to $750 billion annually.  If you think it's bad now, just wait until the Affordable Health Care Act gets implemented. There's nothing to prevent the wastefulness already inherent in the current Medicare and Medicaid systems. Six major areas of waste identified in the report were:

Unnecessary services: $210 billion Inflated prices: $105 billion
Inefficient delivery of care: $130 billion Improper payments: $70 billion
Excess administrative costs: $190 billion Fraud: $75 billion


A separate investigation conducted by the Center for Public Integrity found "upcoding" Medicare bills alone cost taxpayers about $1.1 billion annually.9 However, while Medicare fraud is becoming increasingly common, it's worth noting that the pharmaceutical industry as a whole is the biggest defrauder of all.10 From over-pricing and false claims for medical services, to gross misconduct and mismanaged care of senior citizens in nursing homes, the pharmaceutical industry leads the pack in health care fraud and abuse – and it's been that way for decades.

Do You Want to Feel Like Yourself Again? Take Control of Your Health

Hundreds of thousands are killed by medical care itself, while others are walking around with far less than stellar health due to conventional treatments. Rates of chronic diseases are through the roof, and we're facing epidemics of obesity, heart disease, diabetes, depression and too many others to list. As a whole, Americans are not healthy – they're tired, depressed, stressed out and often in pain.

As patients, many people have taken their health into their own hands by abandoning this fatally flawed medical model and embracing holistic modalities that can help heal on a body-wide level.

And, if you carefully follow some basic health principles – simple things like exercising, eating whole foods, sleeping enough, getting sun exposure, and reducing stress in your life – you will drastically reduce your need for conventional medical care, which in and of itself will reduce your chances of suffering ill side effects.

My Nutrition Plan can guide you, step by step, toward optimal health. It's now significantly improved and contains a number of updated recommendations, such as the addition of fermented vegetables as a source of healthful probiotic, and using intermittent fasting and high-intensity exercise to really optimize your health.

The Plan is divided into three stages: beginner, intermediate and advanced. If you realize you're already doing all the things included in the beginner's phase, then it may be time to move on to the next phase. If you're new to the site, I encourage you to go through it from the beginning, as it is one of the most powerful tools to truly allow you and your family to avoid disability and take control of your health.

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Sources and References

  • 1 CBS News October 6, 2013
  • 2 See ref 1
  • 3 See ref 1
  • 4 See ref 1
  • 5 MMWR Weekly May 1, 2009
  • 6 New England Journal of Medicine November 25, 2010
  • 7 Council for Disability Awareness
  • 8 The Institute of Medicine, Best Care at Lower Cost: The Path to Continuously Learning Health Care, September 6, 2012
  • 9 The Washington Post September 15, 2012
  • 10 Pharmaceutical Industry Is Biggest Defrauder of the Federal Government under the False Claims Act, New Public Citizen Study Finds
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